bluuebunny/crossref_metadata_2025_split huggingface dataset:
Standard Method for Describing an Electronic Patient Record Template: Application of XML to Share Domain Knowledge
Authors: Yamazaki S. , Satomura Y. 
Published: March 2018

Abstract:A Template Definition Language (TDL) was developed to share knowledge of how to construct an electronic patient record (EPR) template. Based on the extensible markup language XML, TDL has been designed to be independent of EPR platforms or databases. Our research of TDL was conducted through evaluation of the description of various templates in the currently available EPRs and through comparisons with some electronic clinical guidelines. We conclude that TDL is sufficient for the objective but still needs improvement of the algorithm for describing dynamic changes.
Reconstructing Bifurcation Diagrams of Dynamical Systems Using Measured Time Series
Authors: Pakdaman K. , Nomura T. , Sato S. , Bagarinao E. 
Published: March 2018

Abstract:We present an algorithm for reconstructing the bifurcation structure of a dynamical system from time series. The method consists in finding a parameterized predictor function whose bifurcation structure is similar to that of the given system. Nonlinear autoregressive (NAR) models with polynomial terms are employed as predictor functions. The appropriate terms in the NAR models are obtained using a fast orthogonal search scheme. This scheme eliminates the problem of multiparameter optimization and makes the approach robust to noise. The algorithm is applied to the reconstruction of the bifurcation diagram (BD) of a neuron model from the simulated membrane potential waveforms. The reconstructed BD captures the different behaviors of the given system. Moreover, the algorithm also works well even for a limited number of time series.
Design and Implementation of a Computer Decision Support System for the Diagnosis and Management of Dementia Syndromes in Primary Care
Authors: Austin T. , Wilcock J. , Bryans M. , Turner S. , Downs M. , Iliffe S. 
Published: March 2018

Summary

Background:
Diagnosis and management of dementia is a complex process and primary care physicians are under-equipped to deal with uncertainties in the provision of optimal care for the patient.

Objective:
To develop a computer decision support system (CDSS) which could assist physicians with diagnosis and management and improve patient care.
Methods:
A design group including general practitioners derived logic pathways for diagnosis and management of dementia and validated them with a multi-professional expert group. Logic pathways were used to construct a comprehensive CDSS rendered as a series of expert consultations. The CDSS was inserted into commercially available GP systems and bench and field-tested.

Results:
The complexity of dementia diagnosis and management can be captured in logic pathways which can be expressed as decision trees within existing electronic patient records. The resulting CDSS appears useable in routine practice.

Conclusion:
The impact of this CDSS will be evaluated in a randomised controlled trial of educational interventions in primary care.
Patient-doctor Concordance in Elderly Women’s Self-reported Health and Medical Records
Authors: Hjerppe M. , Timpka T. , Ockander M. 
Published: March 2018

Summary

Objectives:
To compare the chronic diseases mentioned by elderly women in an interview study with those documented in their respective medical records.

Methods:
The prevalence of positive diagnoses, overall agreement, and the kappa-coefficient were calculated for each group of diagnoses.

Results:
The lowest overall agreement was observed for psychiatric diseases, followed by diseases of the gastrointestinal system. Poor chance-adjusted agreement was found concerning diseases of the gastrointestinal system and diseases of the skin.

Conclusions:
The results suggest that a main reason for discordance was that the elderly women feared »losing face« by reporting some diseases.
Ordinal Classification in Medical Prognosis
Authors: König J. , Feldmann U. 
Published: March 2018

Summary

Objectives:
Medical prognosis is commonly expressed in terms of ordered outcome categories. This paper provides simple statistical procedures to judge whether the predictor variables reflect this natural ordering.

Methods:
The concept of stochastic ordering in logistic regression and discrimination models is applied to naturally ordered outcome scales in medical prognosis.

Results:
The ordering stage is assessed by a data-generated choice between ordered, partially ordered, and unordered models. The ordinal structure of the outcome is particularly taken into consideration in the construction of allocation rules and in the assessment of their performance. The specialized models are compared to the unordered model with respect to the classification efficiency in a clinical prognostic study.

Conclusions:
It is concluded that our approach offers more flexibility than the widely used cumulative-odds model and more stability than the multinomial logistic model. The procedure described in this paper is strongly recommended for practical applications to support medical decision-making.
Representing and Processing Medical Knowledge Using Formal Concept Analysis
Authors: Schnabel M. 
Published: March 2018

Summary

Objectives:
The aim is to show the flexibility, adequateness, and generality of formal concept analysis (FCA) applied to expert systems in medicine.

Methods:
The basic idea of formal concept analysis is to look at a set of objects together with their attributes (formal context) under a definite mathematical view. This view leads to a mathematical structure, a complete lattice, which can be represented graphically.

Results:
Some examples show that this method is very general and can be used to describe diseases, relationships between diseases and findings, the inference process, and, among others, types of uncertainty. For many applications, the adequateness of this method, concerning the underlying semantics, can easily be made plausible.

Conclusions:
FCA can be used to analyze data that can be described by objects and attributes of any kind. The selected examples (diseases, patient cases, therapeutic decisions, rules) show the usefulness of this method. Although it is not difficult to transform the relevant semantics into a formal context in many cases, much more experience is necessary.
Recommendations of the International Medical Informatics Association (IMIA) on Education in Health and Medical Informatics
Authors: Knaup Petra , Haux Reinhold 
Published: March 2018

AbstractThe International Medical Informatics Association (IMIA) agreed on international recommendations in health informatics/medical informatics education. These should help to establish courses, course tracks or even complete programs in this field, to further develop existing educational activities in the various nations and to support international initiatives concerning education in health and medical informatics (HMI), particularly international activities in educating HMI specialists and the sharing of courseware.The IMIA recommendations centre on educational needs for healthcare professionals to acquire knowledge and skills in information processing and information and communication technology. The educational needs are described as a three-dimensional framework. The dimensions are: 1) professionals in healthcare (physicians, nurses, HMI professionals, …), 2) type of specialisation in health and medical informatics (IT users, HMI specialists) and 3) stage of career progression (bachelor, master, …).Learning outcomes are defined in terms of knowledge and practical skills for healthcare professionals in their role (a) as IT user and (b) as HMI specialist. Recommendations are given for courses/course tracks in HMI as part of educational programs in medicine, nursing, healthcare management, dentistry, pharmacy, public health, health record administration, and informatics/computer science as well as for dedicated programs in HMI (with bachelor, master or doctor degree).To support education in HMI, IMIA offers to award a certificate for high quality HMI education and supports information exchange on programs and courses in HMI through a WWW server of its Working Group on Health and Medical Informatics Education (http://www.imia.org/wg1).
Positioning the Patient: Normative Analysis of Electronic Patient Records
Authors: van der Ploeg I. 
Published: March 2018

Summary
Objective: This paper aims to take the current ethical research on electronic patient records beyond the ethical-legal issues of privacy to include contemporary issues of the ‘politics of technology’ and ‘value sensitive design’.
Methods: The paper employs an interpretive approach to analyze research on electronic patient records with concepts of the politics of technology and value sensitive design.
Results and Conclusions: The broad development towards computerization of patient records lacks needed attention to the potential effects of such systems on the patients. This paper argues for a broader understanding of the normative aspects involved in the design and implementation of electronic patient records (EPRs). It suggests three supplemental dimensions for normative analysis of EPR design relevant to the position of the patient: presence, agency, and identity. These dimension are discussed and illustrated as concepts connecting ethical dimensions of patienthood with design features of EPRs.
Quality of Health Care: Informatics Foundations
Authors: Safran C. , Takeda H. , Hasman A. 
Published: March 2018

Summary

Objective:
To discuss in what ways computer systems can contribute to the quality of healthcare and on which principles of informatics successful systems are based.

Methods:
Part of the information was obtained via a literature search and part is based on the knowledge of the authors.

Results:
The results of the literature search are reported. The answers to the questions whether decision support is useful and which factors determine its success, the foundations of computerized guidelines systems and applications of physician order entry and medical risk management are presented. Conclusions: Despite many publications concerning diagnostic support systems their use in clinical practice is limited. Reminder systems do appear to have an impact on health outcomes. Standards for guideline models are being developed for effective sharing of guidelines across systems. Electronic patient records and physician order entry systems are useful aids in medical risk management.
Architecture Models to Facilitate Communication of Clinical Information
Authors: Kay S. 
Published: March 2018

AbstractThis is an account of the development and use of a context model for facilitating the communication of clinical information. Its function is to articulate the principle of context within a reference architecture for the Electronic Health Care Record (EHCR). The work required a re-examination of established models of communication, the purpose being to use them to support an architecture that could be reasonably expected to accommodate future, and by definition unforeseeable, developments in EHCR communication. The Context Model is built upon seven recognized constituents of communication. These constituents, although having their origin in the engineering of signal communication, have been found to be useful for explication both in the verbal and textual communication of narratives between people. The electronic health care record architecture supported by the model is the European prestandard ENV13606-1.
Clinical Terminology: Why Is it so Hard?
Authors: Rector A. L. 
Published: March 2018

AbstractDespite years of work, no re-usable clinical terminology has yet been demonstrated in widespread use. This paper puts forward ten reasons why developing such terminologies is hard. All stem from underestimating the change entailed in using terminology in software for ‘patient centred’ systems rather than for its traditional functions of statistical and financial reporting. Firstly, the increase in scale and complexity are enormous. Secondly, the resulting scale exceeds what can be managed manually with the rigour required by software, but building appropriate rigorous representations on the necessary scale is, in itself, a hard problem. Thirdly, ‘clinical pragmatics’ – practical data entry, presentation and retrieval for clinical tasks – must be taken into account, so that the intrinsic differences between the needs of users and the needs of software are addressed. This implies that validation of clinical terminologies must include validation in use as implemented in software.
Development of a Health Guidance Support System for Lifestyle Improvement
Authors: Tanaka Y. , Shibata S. , Tohyama S. , Ohtsuka Y. , Hattori M. , Kashihara H. , Nasu S. , Usuda T. , Sasamori N. , Aoshima T. 
Published: March 2018

Summary

Objective:
To provide automated advice for lifestyle adjustment based on an assessment of the results of a questionnaire and medical examination or health checkup data.

Methods:
A system was developed that gathers data based on questions regarding weight gain, exercise, smoking, sleep, eating habits, salt intake, animal fat intake, snacks, alcohol, and oral hygiene; body mass index, resting blood pressure, fasting blood sugar, total cholesterol, triglycerides, uric acid and liver function tests. Based on the relationships between the lifestyle data and the health checkup data, a health assessment sheet was generated for persons being allocated to a multiple-risk-factor syndrome group.

Results:
Health assessment and useful advice for lifestyle improvement were automatically extracted with the system, toward the high risk group for lifestyle related diseases. The system is operational.

Conclusions:
We developed a health guidance support system for lifestyle improvement. In comparison with conventional, limited advice methods, we developed a practical system that defined the necessity for lifestyle improvement more clearly, and made giving advice easier.
Validity of the Framingham Risk Model Applied to Japanese Men
Authors: Sugimori H. , Yoshida K. , Suka M. 
Published: March 2018

Summary

Objectives:
To examine whether the Framingham Risk Model can appropriately predict coronary heart disease (CHD) events detected by electrocardiography (ECG) in Japanese men.

Methods:
Using the annual health examination database of a Japanese company 5611 male workers, between the ages of 30 to 59, who were free of cardiovascular disease, were followed up to observe the occurrence of CHD events detected by ECG over a period of five to seven years. The probability of CHD was calculated for each individual from the equations of the Framingham risk model (with total cholesterol).

Results:
The incidence of CHD increased with the estimated CHD risk. The Hosmer-Lemeshow goodness of fit test showed an adequate fit of the risk model to the data of the study subjects. In the receiver operating characteristic analysis, the area under the curve reached 0.67 which indicated an acceptable discriminatory accuracy of the risk model.

Conclusions:
The Framingham risk model provides useful information on future CHD events in Japanese men.
EEG Frequency and Phase Coupling during Human Information Processing
Authors: Rappelsberger P. , Vath N. , Weiss S. , Möller E. , Grießbach G. , Witte H. , Schack B. 
Published: March 2018

AbstractNeuronal activity during information processing is represented by oscillations within local or widespread neuronal networks. These oscillations may be recorded by the EEG (electroencephalogram). The oscillatory interaction between neuronal ensembles may be at one single frequency or at different frequencies due to non-linear coupling. The investigation of momentary coherence and phase enables the examination of synchronized oscillatory network activity during fast-changing cognitive processes. On this basis information transfer from occipital areas towards frontal areas could be described during processing of visual presented words. Non-linear phase coupling between oscillations with different frequencies during memory processing was detected by means of cross-bicoherence.
Flexible Two-Stage Designs: An Overview
Authors: Brannath W. , Posch M. , Bauer P. 
Published: March 2018

AbstractIn this overview we introduce the basic ideas behind a new flexible approach in sequential designs. The different concepts based on two-stage combination tests and conditional error functions are brought together. We sketch the construction of p-values, confidence intervals, and median unbiased estimates. Finally, recursive combination tests are introduced which extend the flexibility to the choice of the number of interim analyses.
Cooperative Problem Solving with Personal Mobile Information Tools in Hospitals
Authors: Buchauer A. , Werner R. , Haux R. 
Published: March 2018

Abstract:Health-care professionals have a broad range of needs for information and cooperation while working at different points of care (e.g., outpatient departments, wards, and functional units such as operating theaters). Patient-related data and medical knowledge have to be widely available to support high-quality patient care. Furthermore, due to the increased specialization of health-care professionals, efficient collaboration is required. Personal mobile information tools have a considerable potential to realize almost ubiquitous information and collaborative support. They enable to unite the functionality of conventional tools such as paper forms, dictating machines, and pagers into one tool. Moreover, they can extend the support already provided by clinical workstations. An approach is described for the integration of mobile information tools with heterogeneous hospital information systems. This approach includes identification of functions which should be provided on mobile tools. Major functions are the presentation of medical records and reports, electronic mailing to support interpersonal communication, and the provision of editors for structured clinical documentation. To realize those functions on mobile tools, we propose a document-based client-server architecture that enables mobile information tools to interoperate with existing computer-based application systems. Open application systems and powerful, partially wireless, hospital-wide networks are the prerequisites for the introduction of mobile information tools.
Randomized Observational Studies on the Economics of Therapies – Biometrical Experience of Two Trials
Authors: Högel J. , Rodloff A. C. , Büchele G. , Gaus W. 
Published: March 2018

Abstract:Economic studies in medicine are intended to investigate costs, associated with a particular problem dealing with the indication, diagnosis or therapy, for instance, whether the high costs involved in a highly intensive or innovative therapy could be balanced by the eventual savings made, due to the shorter periods of treatment. In such situations a randomized controlled trial is necessary to find out which therapy or which therapeutical strategy is least expensive in the long run. Economic studies do, however, present some specific problems. Making a list of all the cost-relevant treatment items can be very laborious, but the use of flat rates and lump sums alone cannot lead to a complete cost analysis. Often, costs between hospitals vary more than between treatment regimens.Early and sudden deaths incur low costs and may bias the results. Furthermore, costs are distributed with a long and heavy upper tail incltJding extreme outliers. This does, in fact, complicate the estimation of the sample size. In this article, these problems are outlined and, with the help ofthe data obtained from two randomized economic trials in health care, solutions are proposed and discussed.
The LYMFASIM Simulation Program for Modeling Lymphatic Filariasis and its Control
Authors: Subramanian S. , Das P. K. , Souza W. , Lapa T. , Furtado A. F. , Van der Ploeg C. P. B. , Habbema J. D. F. , van Oortmarssen G. J. , Plaisier A. P. 
Published: March 2018

Abstract:The LYMFASIM modeling framework for the transmission and control of the tropical parasitic disease lymphatic filariasis is described and its use in the context of an endemic community in north-eastern Brazil is illustrated. Lymphatic filariasis is a disease with a complex natural history with many unknowns. This complicates decision making with respect to control strategies. With LYMFASIM, a variety of hypotheses can be tested about the life history of the parasite Wuchereria bancrofti, its transmission from man to man through mosquitoes, the role of the immune system in regulating parasite numbers, the development of disease symptoms, and the effects of control measures (drug treatment or mosquito control). The implications of alternative assumptions and uncertainty about the quantification of parameters for the effectiveness of control strategies can be investigated. Thanks to the use of stochastic microsimulation, LYMFASIM is highly flexible and can be adapted and extended as new knowledge emerges.
Towards a National Patient Card System in Japan
Authors: Takahashi T. , Minato K. , Alkhateeb A. 
Published: March 2018

Abstract:Patient Card Systems (PCS) have been applied on a regional level to improve access to patient information. However, current projects lack a vision of future integration on a national level. In addition, Integrated Circuit cards and optical cards were introduced without considering that their cost and capacity limits impose significant constraints for future integration. The major arguments against PCS are the huge costs incurred by such a system and the limitations of the card capacities. In addition, standards and legislation have not been sufficiently developed. In this study, we propose a new model of PCS that employs recent communication and card technologies as a key to access a national medical information center. We demonstrate that PCS are feasible if implemented in several distinct phases and if the acceptance and cooperation of physicians and patients are achieved. However, political consensus about the necessity of reform in the health care sector must be established so that the necessary legislation can be enacted.
European Influenza Surveillance Scheme on the Internet
Authors: Manuguerra J. C. , Taylor P. , Snacken R. 
Published: March 2018

AbstractIn 1995, The European Influenza Surveillance Scheme was created with the participation of eight networks from seven countries. The main objectives were to continue the previous CARE Telematics Network and to adapt the project to the Internet environment as well as to improve substantially the quality of the surveillance according to new epidemiological requirements. Clinical and virological data from the general population and hospitals are collected in an interactive real-time database which can then be used for data entry, queries and consultations. Research programmes have been undertaken in various fields such as standardisation of clinical data and comparability between countries. Validation and security processes guarantee the quality assurance as well as regular assessment by the steering committee. Two additional countries will participate during the next influenza season (1997-98). This will represent an early warning system in a region of approximately 264 million inhabitants.