bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Decisions for Psychiatric Inpatients and Their Evaluation by a Trained Neural Network
Authors: Stoler M. , Inbar-Saban N. , Saban N. , Modai I. 
Published: March 2018

AbstractNinety-two consecutive treatment decisions regarding psychotic and depressed inpatients were evaluated by a trained neural network. Simultaneous evaluations according to the Brief Psychiatric Rating Scale (BPRS), the Hamilton scale, and the neural network were performed. A 15-point decrease in the BPRS for psychotic patients or a 10-point decrease in the Hamilton scale for depressed patients was the cut-off point for treatment success. The neural network performed similarly to the clinicians. The combined clinician-network success rate reached 79% and was significantly higher than that for each alone. Clinicians and neural network disagreed on 62% of decisions made for depressed patients and on 55% of decisions made for psychotic patients. The proportion of agreement was lower in both diagnostic groups than expected by chance. However, the high success of the combined clinician and neural network decisions and the high rate of mutual disagreement may imply that a combined decision is fruitful.
Risk Adjustment in Outcome Assessment: the Charlson Comorbidity Index
Authors: Sicotte C. , Tilquin C. , D’Hoore W. 
Published: March 2018

AbstractTo measure the burden of comorbid diseases using the MED-ECHO database (Quebec), the so-called Charlson index was adapted to International Classification of Disease (ICD-9) codes. The resulting comorbidity index was applied to the study of inpatient death in a group of 62,456 patients having one of the following conditions: ischemic heart disease, congestive heart failure, stroke, or bacterial pneumonia. Multiple logistic regression was used to relate inpatient death to its predictors, including gender, principal diagnosis, age, and the comorbidity index. Various transformations of the comorbidity score were performed, and their effect on predictive accuracy was assessed. The comorbidity index was constantly and strongly associated with death. When gender, age, comorbidity and the principal diagnoses were taken into account, the area under the receiver-operating curve was 0.83. Therefore, the Charlson Index is a useful approach to risk adjustment in outcomes research from administrative databases.
An Integrated Knowledge-Based System to Guide the Physician During Structured Reporting
Authors: Zemmler T. , Reichert M. , Rösner D. , Baumiller O. , Knapp H. , Kuhn K. 
Published: March 2018

Abstract:A routinely used system for report generation, based on direct physician data entry, has been combined with a knowledge-based module. The knowledge-based system is operating in the background, and guides the user by dynamically suggesting diagnoses and generating hints regarding the actual and possible further diagnostic procedures. Hybrid technology with neural networks and rules is used. A laboratory evaluation has shown good agreement between diagnoses suggested by the system and confirmed diagnoses, with a kappa coefficient of 0.85 and an area under the ROC curve of 0.92. In a survey following a 14-day test period, physicians stated that the system was both sensible and helpful. The current application domain is ultrasound reporting.
An Intelligent Computer-Assisted Instruction System for Clinical Case Teaching
Authors: Fontaine D. , Riou C. , Jacquelinet C. , Le Beux P. 
Published: March 2018

Abstract:The use of computers in the field of medical education is common. Our purpose is to present a Computer-Assisted Instruction system which has been developed over ten years at the University of Compiegne and the University of Rennes Medical School. This system can be used to help the student to solve clinical cases by analyzing and critiquing their answers and by using a knowledge base which has been previously structured in a rule network. It is an intelligent Computer-Assisted Instruction system comprising an author module, a pedagogical module and a student module. The CAI system can be used as a simulation model for any type of diagnostic or therapeutic problem. In this paper we present the author and pedagogical module which have been built using our previous work on intelligent computer-assisted instruction systems.
A Model for Structured Data Entry Based on Explicit Descriptional Knowledge
Authors: van Ginneken A. M. , van der Lei J. , van Bemmel J. H. , Moorman P. W. 
Published: March 2018

Abstract:Clinical narratives in patient records are usually recorded in free text, limiting the use of this information for research, quality assessment, and decision support. This study focuses on the capture of clinical narratives in a structured format by supporting physicians with structured data entry (SDE). We analyzed and made explicit which requirements SDE should meet to be acceptable for the physician on the one hand, and generate unambiguous patient data on the other. Starting from these requirements, we found that in order to support SDE, the knowledge on which it is based needs to be made explicit: we refer to this knowledge as descriptional knowledge. We articulate the nature of this knowledge, and propose a model in which it can be formally represented. The model allows the construction of specific knowledge bases, each representing the knowledge needed to support SDE within a circumscribed domain. Data entry is made possible through a general entry program, of which the behavior is determined by a combination of user input and the content of the applicable domain knowledge base. We clarify how descriptional knowledge is represented, modeled, and used for data entry to achieve SDE, which meets the proposed requirements.
Mixed Bayesian Networks: A Mixture of Gaussian Distributions
Authors: Chevrolat J. P. , Rutigliano F. , Golmard J. L. 
Published: March 2018

Abstract:Mixed Bayesian networks are probabilistic models associated with a graphical representation, where the graph is directed and the random variables are discrete or continuous. We propose a comprehensive method for estimating the density functions of continuous variables, using a graph structure and a set of samples. The principle of the method is to learn the shape of densities from a sample of continuous variables. The densities are approximated by a mixture of Gaussian distributions. The estimation algorithm is a stochastic version of the Expectation Maximization algorithm (Stochastic EM algorithm). The inference algorithm corresponding to our model is a variant of junction three method, adapted to our specific case. The approach is illustrated by a simulated example from the domain of pharmacokinetics. Tests show that the true distributions seem sufficiently fitted for practical application.
Modeling the Relational Complexities of Symptoms
Authors: Dolin R. H. 
Published: March 2018

Abstract:Realization of the value of reliable codified medical data is growing at a rapid rate. Symptom data in particular have been shown to be useful in decision analysis and in the determination of patient outcomes. Electronic medical record systems are emerging, and attempts are underway to define the structure and content of these systems to support the storage of all medical data. The underlying models upon which these systems are being built continue to be strengthened by a deeper understanding of the complex information they are to store. This report analyzes symptoms as they might be recorded in free text notes and presents a high-level conceptual data model representation of this domain.
Neues aus der neuromuskulären Grundlagenforschung
Authors: Schröder R. , Gautel M. 
Published: March 2018

ZusammenfassungDie neuromuskuläre Forschung hat revolutionäre Erweiterungen des technischen Repertoires erlebt. Die vorliegende Arbeit diskutiert die wesentlichen Entwicklungen auf den Gebieten der genetischen Diagnostik, der “Omics”-Anwendungen vom Epigenom bis zum Proteom, der Genom-Editierung in Tierund Zellmodellen sowie neue optische Bildgebungsverfahren, die sowohl die neuromuskuläre Grundlagenforschung als auch die translationale und klinische Forschung transformieren.
Update Muskelbiopsiediagnostik neuromuskulärer Erkrankungen
Authors: Weis J. , Stenzel W. 
Published: March 2018

ZusammenfassungDie Muskelbiopsie ist ein wichtiges Instrument in der Diagnostik von Krankheiten der Muskulatur und des Nervensystems. Die histologischen, immunhistochemischen, elektronenmikroskopischen und molekularpathologischen Methoden der Aufarbeitung von Muskelbiopsien sind stetig optimiert worden. Zusammen mit den verbesserten klinischen, elektrophysiologischen, laborchemischen und molekulargenetischen Methoden und den bildgebenden Verfahren trägt diese Entwicklung dazu bei, dass neuromuskuläre Krankheiten heute wesentlich differenzierter diagnostiziert werden als noch vor wenigen Jahren. Die Indikation einer Muskelbiopsie sollte sorgfältig erörtert werden, da es sich um einen rein diagnostischen, invasiven Eingriff handelt. Die Biopsien sollten ausschließlich von Personen entnommen und weiterverarbeitet werden, die in der Auswahl des zu biopsierenden Muskels und den anzuwendenden Techniken erfahren sind.
Charcot-Marie-Tooth-Erkrankungen
Authors: Young P. , Dräger B. 
Published: March 2018

ZusammenfassungDie Gruppe der hereditären Neuropathien (Charcot-Marie-Tooth-Erkrankungen, CMT) ist eine klinisch und genetisch heterogene Gruppe von peripheren Neuropathien. Die Prävalenz beträgt 1:2 500, womit die CMT zu den seltenen Erkrankungen zählen. In der klinischen Neurologie stellen sie die häufigste neurogenetische Erkrankung dar. Die CMTFormen mit sensiblen und motorischen Symptomen sind am häufigsten. Neben diesen Formen gibt es rein sensible Formen, mit oder ohne autonome Symptome (HSAN), rein motorische Neuropathien (dHMN) und die besondere Form der hereditären Neuropathie mit Neigung zu Druckparesen (HNPP). Die molekulargenetische Diagnostik wurde zunehmend weiterentwickelt. Die Gendiagnostik ist integraler Bestandteil der Diagnostik für Patienten mit dem klinischen Verdacht auf das Vorliegen einer hereditären Neuropathie. Die klinische und genetische Zuordnung ist durch die große Heterogenität des Phänotyps bei über 80 potenziell krankheitsverursachenden Genen oft sehr erschwert. Trotzdem werden über 90% aller genetisch gesicherten CMT durch Mutationen in vier Genen (PMP22, Cx32, MPZ und MFN2) geklärt. Diese stellen die klinisch relevanten Kandidatengene im klinischen Alltag dar.
Long Range Medical Follow-up and Updating of Computerized Records
Authors: Martin J. M. , Pointel J. P. , Martin J. , Debry G. 
Published: March 2018

In order to follow the clinical course of patients with chronic diseases, it is necessary to have a system for updating their computerized record.To achieve this objective, it is necessary to minimize the length of time devoted to information collecting and to feed the data into the computer in a manner which satisfies two essential criteria:— easy filing process,— easy access to the data for searches.In this article we will consider five aspects of the updating process of a computerized record : a file of records, any record, any elementary item, the lexicon of notions, the results of questioning before and after updating.With such a tool in hand, one can perform longitudinal studies using the data contained in the records. The approach of the authors is not only a formal one. They set up some basic formal principles from an existing experience of processing the data of several thousands of patients with diabetes and give a condensed description of the existing system.
»Hands on« Computer Tabulation of a Cumulative Case Register
Authors: Grad de Alarcon Jacqueline , Evans J. 
Published: March 2018

A method of interrogating a continuously updated psychiatric case register via a flexible user-access package is described. Users request cross-tabulations and case-listings direct from the machine using natural language to specify their own cross-tabulation keys and table selections. Tabulation facilities include both event-based and person-based counts. Time-axis keys cover the whole period of the register’s lifetime. Analysis may take place within customary prevalence models of care or within experimental conceptual models, periodicities and spell constructs developed by users.The paper explains how complex cumulative register information can be organised to enable these analytic facilities to be made directly available to lay users.The package circumvents the programming barrier which hinders full exploitation of computerised registers, allowing lay users to extract their own epidemiological and service-evaluation data, without specialist programmer intervention.
Power and Sample Size Determination in Survival Time Studies with Special Regard to the Censoring Mechanism
Authors: Schumacher M. 
Published: March 2018

When calculating the power and sample size in survival time studies for the comparison of two treatments censoring has to be taken into account.In most medical applications only vague information about the shape of the underlying distributions is available. Thus, a distribution-free procedure based on the McNemar test is proposed and compared with other methods.
Analyzing Medicine by Means of Reprint Requests
Authors: Onuigbo W. I. B. 
Published: March 2018

SummaryAuthors are commonly asked for reprints of their publications. There is need to promote awareness of the usefulness of such requests in gathering medical information. By way of illustration, this study focusses on how requests from the United States of America enabled an African author to collect interesting data on that country’s military medicine with reference to such parameters as the specialties of the requesters, the selective nature of their requests, and even women’s inferior position in science. It is concluded that the reprint request is a neglected tool which has research potentialities in medical informatics.
Present State of the Medical Expert System CADIAG-2
Authors: Adlassnig K.-P. , Kolarz G. , Scheithauer W. 
Published: March 2018

SummaryUncertainty of knowledge about the patient and about medical relationships is generally accepted and considered to be an inherent concept in medicine. The physician, however, is quite capable of drawing conclusions from this information. Naturally, these conclusions are approximate rather than precise.Fuzzy set theory provides the possibility of defining imprecise medical entities as fuzzy sets. It offers a linguistic concept with excellent approximation to medical texts. In addition, fuzzy logic presents powerful reasoning methods that can handle approximate inferences. These facts make fuzzy set theory highly suitable for the development of computer-based medical diagnostic systems.The medical expert system CADIAG-2 provides evidence that fuzzy set theory is a suitable mathematical tool for formalizing medical processes.CADIAG-2/RHEUMA is being extensively tested on cases from a rheumatological hospital. Results from 327 cases are presented. In 265 cases, i.e. 81%, the clinical diagnosis could be either confirmed (223 cases, i.e. 68.2%) or established as a diagnostic hypothesis (42 cases, i.e. 12.8%).CADIAG-2/PANCREAS was tested on 47 cases of pancreatic diseases. In 43 cases, i.e. 91.5%, the clinical diagnosis was either confirmed by CADIAG-2 or established as one of the hypotheses with the highest or second highest number of points in a ranked list of hypotheses.
Data Quality Assurance for a Health Monitoring Program
Authors: Finkelstein S. M. , Budd J. R. , Ewing Lisa B. , Catherine L. , Warwick W. J. , Kujawa Sue J. 
Published: March 2018

AbstractThe objective of data quality assurance procedures in clinical studies is to reduce the number of data errors that appear on the data record to a level which is acceptable and compatible with the ultimate use of the recorded information. A semi-automatic procedure has been developed to detect and correct data entry errors in a study of the feasibility and efficacy of home health monitoring for patients with cystic fibrosis. Daily self-measurements are recorded in a diary, mailed to the study coordinating center weekly, and entered into the study’s INSIGHT clinical database. A statistical error detection test has been combined with manual error correction to provide a satisfactory, reasonable cost procedure for such a program. Approximately 76% of the errors from a test diary entry period were detected and corrected by this method. Those errors not detected were within an acceptable range so as not to impact the clinical decisions derived from this data. A completely manual method detected SS% of all errors, but the review and correction process was four times more costly, based on the time needed to conduct each procedure.
Sources of Information for Biomedical Decision-Making
Authors: Osiobe St. A. 
Published: March 2018

SummarySources of information used by health professionals for research, teaching, patient care and miscellaneous information demands were determined by means of a questionnaire survey. The results of the survey indicate that, for purposes of research, scientific and technical journals are the most frequently -used sources, followed by abstracts and indexes, private information files and monographs/textbooks. For teaching purposes, monographs/textbooks are the most frequently used source, followed by private information files, scientific/technical journals and seminars, workshops, and conferences. Patient care information needs are most frequently satisfied by use of scientific/technical journals, personal contact with colleagues, and monographs/textbooks, while miscellaneous information demands are satisfied by use of scientific/technical journals, private information files, and non-academic journals and newspapers.
PaperChase: Computerized Bibliographic Retrieval to Answer Clinical Questions
Authors: Horowitz G. L. , Jackson J. D. , Bleich H. L. 
Published: March 2018

PaperChase is a computerized bibliographic retrieval system that permits users without previous training to search the medical literature themselves at any time of the day or night. The database for PaperChase consists of approximately 425,000 references from 258 journals dating back eight years—nearly all the references shelved in the library of our hospital. In its first year of deployment, 1,032 users conducted 8,459 searches, during which they displayed 399,821 references and selected 97,869 of them for printing.The most common reason for using PaperChase is to answer a question of medical importance. As the results of the search are displayed, the titles of the retrieved references flash by; often one or more of them contain a declarative medical statement that answers the question of interest. To facilitate rapid review of these medical statements, we provided a new means to display references—just the titles, but four at a time. Examples are given which illustrate how users of PaperChase can find what they are looking for without consulting bound volumes.
Strain Gauge Venous Occlusion Plethysmography: Evidence of a Trend in Repeated Blood Flow Measurements
Authors: Gizdulich P. , Mlchelutti M. 
Published: March 2018

Strain gauge venous occlusion plethysmography continues to be employed for peripheral muscular blood flow measurements, even though its reliability is dubious.We have already studied reproducibility for short-term (several minutes) and for long-term (one or two days) measurements. Our present aim is to analyze medium-term (several hours) reproducibility, keeping in mind the application of this technique in pharmacological experimentation.We used an analysis of variance with repeated measurements over 4 hours in 24 healthy subjects, considering the following variation factors: venous occlusion pressure (vop); muscular activity; the sampling interval. Two levels were assigned to each factor: 30 or 50 mmHg for the vop, yes or no for the muscular activity and 5 or 20 minutes for the sampling interval.We verified (p <.01) a mean decreasing trend. After an initial 15% increase, values decreased to 85% of the initial value. The trend appears to be modified only by vop. As for the mean value, independently from the trend, we verified that it is significantly (p < .05) modified by muscular activity—as expected—and by the sampling time interval. The statistical analysis excludes trend shape dependence on different metabolic requirements due to the duration of the experiment.
Building an Expert Critiquing System: ESSENTIAL-ATTENDING
Authors: Miller P. L. 
Published: March 2018

SummaryThis paper describes a “system-building system”, ESSENTIAL-ATTENDING (E-ATTEND-ING), designed to assist in the implementation of expert systems which critique a physician’s plan for patient care. E-ATTENDING has been refined during the implementation of several developmental critiquing systems and may be applied in areas of medical management, patient workup, and differential diagnosis. E-ATTENDING is currently designed to help implement a class of critiquing systems in a subset of possible critiquing domains. It can also be augmented in various ways by interested users to accommodate critiquing domains with more complexity.
ELSA – A Method for Medical Knowledge Acquisition and Processing to Aid Medical Reasoning
Authors: Ruszkowski J. 
Published: March 2018

SummaryExperts’ Lattice-Structured Acquirements (ELSA) is a method of medical experts’ knowledge management which aims at aiding clinical problem solving by various ways and forms, from simple procedures of clinical data evaluation to computer-aided consultation and teaching systems in all fields of medicine. The concept of the ELSA method is based upon the assumption of the relational nature of medical reasoning and clinical decision making in man. Furthermore, there are some reasons to judge that physicians rather use qualitative clinical data or quantitative ones converted into qualitative ones in their clinical thinking. Two stages of method performance have been described: First, the data acquisition concerned with total decomposition of a medical problem to as simple as possible questions to the experts and, second, the composition procedure to be applied to the knowledge structures obtained as experts’ answers. The paper deals with algorithms of how to record and check experts’ knowledge data obtained according to ELSA rules and how to use them for setting up an order relation in diagnostic hypotheses set according to the syndrome of symptoms and signs considered. Some practical applications and evaluations of the method are mentioned.
A Flexible Computer System for Renal Transplant Information
Authors: Fryd D. S. 
Published: March 2018

SummaryRenal transplantation is a life-sustaining treatment for a person whose kidneys cease to function. The duration of graft and patient survival time is extremely variable from patient to patient. A subset of the potential risk factors has been selected for study at the University of Minnesota, where 2,247 renal transplants were performed between January 1, 1968 and December 31, 1985.A computer system for storing and analyzing these risk factors has been successfully implemented at the University of Minnesota. Its design facilitates fast turnaround time, flexibility and timeliness of information. Further, routine operations require a minimum of clinician involvement. A part-time data abstractor collects and updates the information. A full-time biometrician manages and analyzes the data.The renal transplant computer system was implemented in 1976. The system produces reports, generates matched pair control groups and calculates frequencies, crosstabulations and life tables. It is capable of handling clinical trials as well as retrospective studies.
The Prognosis of In Vitro Fertilization (IVF) : a Regression Approach
Authors: Baeten S. , Bouckaert A. , Thomas K. , Loumaye E. 
Published: March 2018

SummaryLogistic regression can be used to investigate prognostic factors in the treatment of infertility by in vitro fertilization (IVF). It was observed that the probability of success is not constant over repeated attempts, but decreases according to a selection process. Another prognostic factor, the number of cells of the largest embryo, was also observed.