bluuebunny/crossref_metadata_2025_split huggingface dataset:
Machine Learning of Motor Vehicle Accident Categories from Narrative Data
Authors: Lehto M. R. , Sorock G. S. 
Published: March 2018

Abstract:Bayesian inferencing as a machine learning technique was evaluated for identifying pre-crash activity and crash type from accident narratives describing 3,686 motor vehicle crashes. It was hypothesized that a Bayesian model could learn from a computer search for 63 keywords related to accident categories. Learning was described in terms of the ability to accurately classify previously unclassifiable narratives not containing the original keywords. When narratives contained keywords, the results obtained using both the Bayesian model and keyword search corresponded closely to expert ratings (P(detection)≥0.9, and P(false positive)≤0.05). For narratives not containing keywords, when the threshold used by the Bayesian model was varied between p>0.5 and p>0.9, the overall probability of detecting a category assigned by the expert varied between 67% and 12%. False positives correspondingly varied between 32% and 3%. These latter results demonstrated that the Bayesian system learned from the results of the keyword searches.
Natural Language Processing in Medicine: An Overview
Authors: Spyns P. 
Published: March 2018

Abstract:An overview is given of natural language processing applications in medicine. An attempt has been made to enumerate the most important and known international projects and to summarize their goals, principles, methods and results. A section is devoted to projects involving the Dutch language. A more general discussion about the two fundamental approaches concerning medical language understanding is provided. An extensive bibliography may be useful for those wishing to explore this research domain.
Review Paper: Coding Systems in Health Care
Authors: Cimino J. J. 
Published: March 2018

Abstract:Computer-based patient data which are represented in a coded form have a variety of uses, including direct patient care, statistical reporting, automated decision support, and clinical research. No standard exists which supports all of these functions. Abstracting coding systems, such as ICD, CPT, DRGs and MeSH fail to provide adequate detail, forcing application developers to create their own coding schemes for systems. Some of these schemes have been put forward as possible standards, but they have not been widely accepted. This paper reviews existing schemes used for abstracting, electronic record systems, and comprehensive coding. It also discusses the remaining impediments to acceptance of standards and the current efforts to overcome them, including SNOMED, the Gabrieli Medical Nomenclature, the Read Clinical Codes, GALEN, and the Unified Medical Language System (UMLS).
Collaborating for Competency—A Model for Single Electronic Health Record Onboarding for Medical Students Rotating among Separate Health Systems
Authors: Pereira Anne , Kim Michael , Seywerd Marcus , Nesbitt Brooke , Pitt Michael ,   on behalf of the Minnesota Epic101 Collaborative
Published: March 2018

Background Use of the electronic health record (EHR) is widespread in academic medical centers, and hands-on EHR experience in medical school is essential for new residents to be able to meaningfully contribute to patient care. As system-specific EHR training is not portable across institutions—even when the same EHR platform is used—students rotating across health systems are often required to spend time away from clinical training to complete each system's, often duplicative, EHR training regardless of their competency within the EHR.
Methods We aimed to create a single competency-based Epic onboarding process that would be portable across all the institutions in which our medical students complete clinical rotations. In collaboration with six health systems, we created online EHR training modules using a systematic approach to curriculum development and created an assessment within the Epic practice environment.
Results All six collaborating health systems accepted successful completion of the developed assessment in lieu of standard site-specific medical student EHR training. In the pilot year, 443 students (94%) completed the modules and assessment prior to their clinical training and successfully entered clinical rotations without time consuming, often repetitive onsite training, decreasing the cumulative time as student might be expected to engage in Epic onboarding as much as 20-fold.
Conclusion Medical schools with multisystem training sites with a single type of EHR can adopt this approach to minimize training burden for their learners and to allow them more time in the clinical setting with optimized access to the EHR.
Die psychosoziale Belastung von Kindern in Frauenhäusern
Authors: Zwönitzer A. , Thurn L. , Fegert J. M. , Ziegenhain U. , Himmel R. 
Published: March 2018

ZusammenfassungKinder sind durch das Miterleben häuslicher Gewalt stark gefährdet. Dabei dürften insbesondere Frauen und Kinder, die in ein Frauenhaus fliehen, zuhause lange und massive Gewalt erlebt haben. Obwohl davon auszugehen ist, dass diese Frauen und Kinder psychisch hoch belastet sind, gibt es in Deutschland keinerlei systematische Studien, deren Ergebnisse helfen könnten, die Frauen und Kinder mit (spezifischen) Angeboten aus bestehenden Helfersystemen bei der Verarbeitung ihrer Gewalterlebnisse besser zu versorgen. Die vorliegende Pilotstudie untersuchte Kinder und ihre Mütter in fünf Frauenhäusern in Baden-Württemberg auf ihre psychische Belastung. Dabei wurden bei den Kindern Verhaltensauffälligkeiten, Symptome von Bindungsstörungen sowie traumatische Erlebnisse erfasst und bei den Müttern ihre psychische Belastung insbesondere hinsichtlich Depressivität. Es stellte sich heraus, dass der Großteil der Kinder und deren Mütter psychisch stark belastet waren.
Schulen stark machen gegen Suizidalität und Selbstverletzung
Authors: Groschwitz R. C. , Straub J. 
Published: March 2018

ZusammenfassungGegenstand und Ziel: Suizidalität und nicht suizidales selbstverletzendes Verhalten (NSSV) zeigen im Jugendalter hohe Prävalenzen. Mitarbeiter des Schulsystems verfügen häufig über unzureichendes Wissen im Umgang mit dieser Symptomatik. Ziel dieser Studie ist die Evaluation eines Workshops für Schulpersonal zu den genannten Themen. Material und Methoden: Es wurden 16 zweitägige Workshops angeboten, die von 257 Personen besucht wurden. Im Zuge von Prä-, Post- und Follow-up(FU)-Erhebungen wurde das Vertrauen in eigene Fähigkeiten, gefühltes und tatsächliches Wissen sowie Einstellungen hinsichtlich NSSV und Suizidalität erhoben. Zudem wurden Zufriedenheit mit dem Workshop und Verhaltensänderungen evaluiert. Ergebnisse: Es zeigte sich eine hohe Zufriedenheit mit dem Workshop. Zuversicht in eigene Fähigkeiten sowie gefühltes und tatsächliches Wissen verbesserten sich stark von Prä nach Post und blieben auch bei FU stabil. Zudem zeigten sich Verhaltensänderungen beim FU. Schlussfolgerungen/Klinische Relevanz: Verbessertes Wissen und Selbstwirksamkeit des Schulpersonals hinsichtlich NSSV und Suizidalität kann einen positiven Einfluss auf den Umgang mit betroffenen Schülern haben.
A Hierarchical Modular Design for Treatment Protocols
Authors: Ben-Bassat M. , Carlson R. W. , Puri V. K. , Weil M. H. 
Published: March 2018

We view a treatment protocol as a hierarchical structure of therapeutic modules. The lowest level of this structure consists of individual therapeutic actions. Combinations of individual actions define higher level modules, which we call routines. Routines are designed to manage limited clinical problems, such as the routine for fluid loading to correct hypovolemia. Combinations of routines and additional actions, together with comments, questions, or precautions organized in a branching logic, in turn, define the treatment protocol for a given disorder.Adoption of this modular approach may facilitate the formulation of treatment protocols, since the physician is not required to prepare complex flow charts. This hierarchical approach also allows protocols to be updated and modified in a flexible manner. By use of such a standard format, individual components may be fitted together to create protocols for multiple disorders. The technique is suited for computer implementation. We believe that this hierarchical approach may facilitate standardization of patient care as well as aid in clinical teaching. A protocol for acute pancreatitis is used to illustrate this technique.
Statistical Recognition of Trends in Health Monitoring Systems
Authors: Brockett P. L. , Kemperman J. H. B. 
Published: March 2018

The determination of when trends are present in an active health monitoring system is considered. The type of data collected is often voluntary response data usually of unknown, or perhaps of low quality or reliability. Often, even if the data themselves are perfectly reliable, the different monitoring stations are usually not comparable in size or scope, so aggregrate measures would tend to mask rather than detect trends for the whole system.Examples of such monitoring systems are the World Health Organization’s Research Center for International Monitoring of Adverse Reactions to Drugs and the »Programa de Investigacion de Modelos Operacionales de Prestacion de Servicios de Salud« (PRIMOPS) operating in Cali, Columbia. We study a »Center-Batch matrix« by using a transformation to a matrix of ranks. It incorporates most of the relevant information. A relatively simple statistical technique is presented for generating a warning signal whenever a pattern of increasing adverse events does occur. This rank Center-Batch method avoids some of the pitfalls of the previous methods used and in fact is often quite superior.
Screening for Cancer: Publications 1971—1980
Authors: Wagner G. , Tautu P. , Wolber U. 
Published: March 2018

The number of publications dealing with different aspects of the problems of screening for cancer is growing so fast that only very few specialists can have a complete knowledge of the literature in this domain. For this reason, we are restricting our compilation to relevant publications from 1971—1980. We deliberately omitted short notes, abstracts, editorials, technical reports, letters to the editor as well as papers written in a language with restricted circulation (e. g. Russian and Japanese). Nevertheless, the bibliography includes almost 1,200 titles.As D. M. Eddy noticed in 1980, the screening problem resembles many other problems in medicine: it is important, it is urgent, but it is also very complicated. We experienced this complexity when trying to fit the many aspects of our topic into a classification. This finally took the following shape:
Implementation of an International Information System on Kidney Transplantation
Authors: Hennige M. 
Published: March 2018

SummaryKidney transplantations are influenced by a number of factors which are as yet partly unknown or correlate, their mutual dependencies being again unknown. Some of these factors are of a regional or organisational nature. One possibility of gaining new knowledge consists in setting up and analysing an extensive database.With the aid of the information system presented, which is part of a worldwide prospective study on kidney transplantations, it has been possible to build up such a database within a period of three years. It contains information on more than 16,000 kidney transplantations including follow-up data. 212 transplantation centers from all over the world participate in this study. First analyses already showed interesting correlations.
A User-oriented Approach to Decision Making in Differential Diagnosis and Therapeutic Advice
Authors: Rao N.G. , Prasad B.E. , Guha S.K. , Reddy P.G. 
Published: March 2018

SummaryA search for a user-oriented, computer-assisted expert system resulted in a simple method of simulation of a human consultant’s thinking and action. Making a quick decision in differential diagnosis and selection of the proper line of treatment when faced with a problematic patient has always been a challenging task for clinicians, especially those working in emergency wards, intensive care wards and acute wards. Consulting a vast memory of a number of past cases of a similar nature is near to the natural behaviour of a medical expert and well acceptable to most of the users and patients alike. In this method, the case details of an undiagnosed fresh patient are compared with the details of similar cases diagnosed and treated earlier by experienced consultants and stored in the computer memory. These old cases with confirmed final diagnoses, proven methods of treatment and correctly recorded outcomes enable the system to arrive at the most likely diagnosis, the next likely diagnosis and the most suitable treatment for the new case.A check facility to ensure the accuracy of the decisions made by MEMCONSULT through comparison with a textbook description and any particular old case in the memory has been added in view of the education and training of newcomers in the field of medicine. A self revising capability depending on the changed clinical condition of the patient is also implemented to suit the basic requirements of an ideal expert system in medicine.
Computerization of the Patient History -Patient Answers Compared with Medical Records
Authors: Quaak M. J. , Westerman R. F. , Schouten J. A. , Hasman A. , Bemmel J. H. 
Published: March 2018

SummaryComputerized medical history taking, in which patients answer questions by using a terminal, is compared with the written medical record for a group of 99 patients in internal medicine. Patient complaints were analysed with respect to their frequency of occurrence for all important tracts, such as the respiratory, the gastro-intestinal and the uro-genital tracts. About 36% of over 3,200 patient answers were identical in the patient record and the written record, but a considerable percentage of complaints (56%), that were present in the patient record, were missing in the written record; the reverse was true for 4.5%. A computerized patient record appears to contain more extensive information about patient complaints, still to be interpreted by the experienced physician.
Evaluation of Some Strategies for Treating Concomitant Factors in Randomized Trials
Authors: Commenges D. 
Published: March 2018

SummaryIn a randomized clinical trial, the design may or may not be stratified, the analysis may or may not be adjusted. The cross-classification of these alternatives leads to four different strategies. These strategies, plus another one, are evaluated within the framework of a linear model. A discussion about the conditional and unconditional points of view throws some light on the problem of bias in a randomized trial.
Basic Principles for the Creation of a National Automated System for Permanent Loss of Working Capacity
Authors: Peevsky T. D. , Gloutnikova Z. N. , Nicholova V. I. 
Published: March 2018

The System for the Observation and Analysis of Disability is part of the Unified National System for Health Service in Bulgaria.The system was designed after a detailed analysis of the incoming documents and their circulation had been performed and after various models had been designed and tested.Some of the basic tables describing the output of the system are shown. The information from these tables is designed for the various levels of administration which are the carriers of social activities in the country and for the management of the Boards of Experts on Industrial Medicine.
Decision-Making in Medical Research and Clinical Practice: Theory and Methodology of Laboratory Data Evaluation by Predictors, Indicators and Indices
Authors: Sebag J. , Hall P. 
Published: March 2018

A method designed to aid clinical decision-making is described. Predictors and Indicators are criteria that reflect the likelihood of disease and health, based on a retrospective analysis of the frequencies of diseases or diagnoses associated with symptoms, signs, and tests (SST’s). The approach is primarily based upon the SST’s of an individual and how these vary over time. This differs from traditional approaches which operate primarily from a disease-or diagnostic-oriented perspective. Such approaches are, therefore, useful in areas of medical research, education, and paraclinical service units, but have a limited value for patient-care. Static and dynamic health indices aid clinical decision-making by summarizing the SST-oriented Predictor and Indicator evaluations into individualized indices that can be monitored over time.The methodology of employing this approach for the evaluation of laboratory data is presented. The application of these techniques to a battery of laboratory tests will be presented in the near future.
Die vollautomatische Dokumentation und statistische Auswertung pathologisch-anatomischer Befundberichte
Authors: Röttger P. , Reul H. , Klein I. , Sunkel H. 
Published: March 2018

Autopsieberichte (»pathologisch-anatomische Diagnosen«) schließen Grundleiden, Einzelorganbefunde, histologische Befunde, Körper- und Organgewichte, Personalien und klinische Diagnosen ein. Für die vollständige Auswertung dieser heterogenen Informationen wurde ein Verfahren entwickelt, das auf der Klartextanalyse basiert. Die im Routinebetrieb anfallenden Berichte werden anstatt auf einer nor-malen Schreibmaschine auf einem Flexowriter geschrieben. Dabei fällt ein Lochstreifen an, der automa-tiscch (IBM 1401) auf Magnetband übertragen wird. Dann werden die Berichte durch einen Computer (IBM 7094) mit einem eigens erstellten, die pathologisch-anatomische Nomenklatur in klassifizierter Form enthaltenden, zur Zeit 38 000 Einheiten umfassenden Thesaurus verglichen und standardisiert. In dieser Speicher-Form werden sie der statistischen Auswertung, für die eigene Programm-Systeme entwickelt worden sind (DRZ, System DL-ASEDC), zugeführt.Nach Erstellung des Thesaurus und der Programme genügt das Verfahren zwei Idealforderungen: 1.) Die Dokumentation — hier die Erstellung des Lochstreifens — erfolgt in einem auch bisher notwen-digen Arbeitsgang ohne zusätzliche Belastung des Routinebetriebes. 2.) Die gespeicherten Informationen sind einer automatischen statistischen Auswertung zuganglich, die alle denkbaren Abfragungen ein-schliefilich der statistischen Sicherung zuläßt.
Zur Erfassung und Verarbeitung medizinischer Daten mittels Computer
Authors: Giere W. , Baumann H. 
Published: March 2018

Es wird ein Programmsystem (DUSP) beschrieben, das die Dokumentation beliebiger Inhalte — kodiert und/oder frei formuliert — mit variablen Wortlängen bei rascher Wiederauffindbarkeit (direkter Zugriff) erlaubt. Die Eingabe erfolgt mit unterschiedlichen, dem Untersuchungsgang angepaßten Erhebungs-bögen über eine Korrespondenzschreibmaschine mit angescblossenem Lochstreifenstanzer. DUSP ermög-licht auch kleineren Abteilungen oder Praktikern in Zusammenarbeit mit einem Rechenzentrum preis-giinstige elektronische Datenverarbeitung. Fachkräfte sind zur Anwendung nicht: erforderlich.Die wesentlichen Charakteristika von DUSP sind:1.) Steuerung der Speicherungsart durch den Benutzer, unabhangig vom Inhalt,2.) Beliebiger Inhalt und beliebige Reihenfolge der Formulare,3.) Zeilenweise Speidierung mit Trennung von evtl. kodiertem »Inhalt« und klartextlichem »Zusatz«,4.) Wirksame Priitung auf formale Riditigkeit beim Einlesen,5.) Nachträgliche Möglichkeit der Korrektur des gespeicherten Inhalts,6.) Wirtschaftlichkeit.
Use of a Computer for Compiling and Holding a Medical Thesaurus
Authors: Wolff-Terroine M. , Simon N. , Rimbert D. 
Published: March 2018

A method is described to compile and hold a medical thesaurus through a combination of intellectual effort and the widest possible use of computerization. Various techniques, such as the automatic generation of relationships among terms, are discussed.Certains suggestions are offered as to the kind of assistance a computer can provide.
Computer Processing of Medical Text Information**)
Authors: Barnett G. O. , Greenes R. A. , Grossman J. H. 
Published: March 2018

The present form of the medical record evolved when patient care was primarily a single physiciansingle patient relationship. However, in recent decades, there have been radical changes in the needs and patterns of health care delivery, and this scrap-book format for a medical record is grossly deficient.The largest portion of the medical record consists of narrative or free text which is hand-written in relatively unstructured, and often illegible, prose. Although the computer can be used for medical record processing by the unmodified entry of data in prose form, there are very critical limitations in such applications. A more challenging approach is to collect the information in an interactive, conversational technique between the user and the computer, where there is a predetermined branching structure of the data and a fixed vocabulary. The information is entered by the user selecting the desired items from a list on a display screen. The presentation of the particular display by the computer is determined by all the previous choices made by the user. This style of collecting information not only insures clear and unambiguous data, but also facilitates continuing medical education, medical audit, and clinical investigation.
An Approach to an Automatic Pattern Recognition of the Electroencephalogram: Background Rhythm and Paroxysmal Elements
Authors: Goldberg P. , Samson-Dollfus D. , Grémy F. 
Published: March 2018

The automatic analysis program for one derivation of E.E.G. described here is made up of two parts:1.) The first part consists of the study of background rhythm. A temporal analysis is made of the signal to identify the waves of which it is composed. Bursts of rhythms are recognised. Then the principal background rhythms are determined by the analysis of histograms of amplitude and frequency. The results are given as the percentage of the total waves, the mean frequency and amplitude and the coefficient of variation of these quantities.2.) The second part is the recognition of paroxysmal patterns. By successive applications of a set of criteria the parts of the E.E.G. which may contain spikes or spike-and-waves are extracted. The criteria are:— existence of large amplitude or slow waves,— comparison of the frequency of these suspect patterns with the background frequency,— comparison of the amplitude of these waves with the mean amplitude of the E.E.G.,— study of the rapid rhythms which, are superimposed on the show waves.This analysis is concluded by the printing of the number of isolated spikes or spike-and-waves that were observed.This program, orientated towards pattern recognition, is suitable for the study of the background patterns as well as the pattern recognition of paroxysmal bursts.
Practical Considerations in Cooperative Therapeutic Trials
Authors: Williams John , Freis Edward 
Published: March 2018

Various practical problems associated with cooperative therapeutic trials are discussed from the experience obtained during the U. S. Veterans Administration Cooperative Study on Antihypertensive Agents. The problems discussed include stratification of patients on the basis of severity, methods and precautions for achieving double-blind _ therapeutic regimens, methods for obtaining uniformity of data in different hospitals, and the need for inserting modifications in the protocol to take care of the patients developing life threatening complications.Other practical problems discussed include the need for obtaining the cooperation of the ward physicians and the problem associated with defaulters and those who do not follow the prescribed regimens. Experimental design helps to restrict errors introduced by variance between hospitals. Cooperative trials have goals and use methods which are somewhat different from the classical methods and aims of laboratory research, and should be evaluated in their proper frame of reference.