bluuebunny/crossref_metadata_2025_split huggingface dataset:
Induction of Hypotheses Concerning Hip Arthroplasty: A Modified Methodology for Medical Research
Authors: Bratko I. , Demšar J. , Smrke D. , Stankovski V. 
Published: March 2018

Summary

Objectives:
The objective of this study is to advocate a methodology for medical research that, in contrast to traditional medical methodology, exploits the flexibility of machine learning and retains the kind of statistical tests that are generally accepted in the medical field for the confirmation of hypotheses.

Methods:
First, the medical problem is defined and data for an observed population are collected; then a machine learning tool is used to generate hypotheses regarding the problem; finally, statistical methods are used to determine the validity of the generated hypotheses.

Results:
To illustrate this approach, the problem of defining indications for hip arthroplasty after an acute medial femoral neck fracture is investigated as a case study.

Conclusions:
The methodology is similar to the usual style of applying machine learning, but insists on a link to the techniques of statistical tests that are normally used in medicine. It aims at a more flexible and economical use of experimental data than in the usual medical research, which is enabled by techniques of machine learning. At the same time, by reference to traditional statistical tests, it is hoped that this approach will lead to improved acceptance of machine learning in the medical field.
Prediction in Medicine by Integrating Regression Trees into Regression Analysis with Optimal Scaling
Authors: Meulman J. J. , Dusseldorp E. 
Published: March 2018

Summary

Objectives:
A new data-analysis strategy is proposed to solve the problems of selecting interaction terms in linear regression on the one hand, and of statistically testing the significance of regression trees on the other hand.

Methods:
The proposed strategy combines two data mining techniques: regression trees and regression analysis with optimal scaling (CATREG). The method traces small regression trees using the bootstrap and integrates the results as interaction variables (called “trunk variables”) into CATREG.

Results:
An application to data from cardiac patients shows a relative increase of 19% variance accounted for (16% cross-validated variance), by the CATREG model including the trunk variables compared to the model excluding these variables.

Conclusions:
This study indicates that trunk variables can be useful to model interaction effects in prediction problems.
Experiences with a Generator Tool for Building Clinical Application Modules
Authors: Lenz R. , Elstner T. , Siegele H. , Moll R. , Kuhn K.A. 
Published: March 2018

Summary
Objectives: To elaborate main system characteristics and relevant deployment experiences for the health information system (HIS) Orbis®/ OpenMed, which is in widespread use in Germany, Austria, and Switzerland.
Methods: In a deployment phase of 3 years in a 1.200 bed university hospital, where the system underwent significant improvements, the system’s functionality and its software design have been analyzed in detail. We focus on an integrated CASE tool for generating embedded clinical applications and for incremental system evolution. We present a participatory and iterative software engineering process developed for efficient utilization of such a tool.
Results: The system’s functionality is comparable to other commercial products’ functionality; its components are embedded in a vendor-specific application framework, and standard interfaces are being used for connecting subsystems. The integrated generator tool is a remarkable feature; it became a key factor of our project. Tool generated applications are workflow enabled and embedded into the overall data base schema. Rapid prototyping and iterative refinement are supported, so application modules can be adapted to the users’ work practice.
Conclusions: We consider tools supporting an iterative and participatory software engineering process highly relevant for health information system architects. The potential of a system to continuously evolve and to be effectively adapted to changing needs may be more important than sophisticated but hard-coded HIS functionality. More work will focus on HIS software design and on software engineering. Methods and tools are needed for quick and robust adaptation of systems to health care processes and changing requirements.
Development and Implementation of Computerized Clinical Guidelines: Barriers and Solutions
Authors: Trivedi M. H. , Kern J. K. , Marcee A. , Grannemann B. , Kleiber B. , Bettinger T. , Altshuler K. Z. , McClelland A. 
Published: March 2018

SummaryNext, the article discusses the need to incorporate the use of surveys, questionnaires, or rating instruments for the collection of end-user feedback during and after the implementation process. A description of the types of rating instruments that will facilitate the assessment of user satisfaction is provided. Initial results from physician feedback during the implementation of our prototype are discussed. Research indicates that computerized decision support systems (CDSSs) can improve clinical performance and patient outcomes, and yet CDSSs are not in widespread use. Physician guidelines, in general, face barriers in implementation. Guidelines in a computerized format can overcome some of the barriers to conventional text-form guidelines; however, computerized programs have novel aspects that have to be considered, aspects such as technical problems/support and user interface issues that can act as barriers. Though the literature points out that human, organizational, and technical issues can act as barriers in the implementation of CDSSs, studies clearly indicate that there are methods that can overcome these barriers and improve CDSS acceptance and use. These methods come from lessons learned from a variety of CDSS implementation ventures. Notably, most of the methods that improve acceptance and use of a CDSS require feedback and involvement of end-users. Measuring and addressing physician or user attitudes toward the computerized support system has been shown to be important in the successful implementation of a CDSS. This article discusses: 1) the barriers of implementation of guidelines in general and of CDSSs; 2) the importance of the physician’s role in development, implementation, and adherence; 3) methods that can improve CDSS acceptance and use; and 4) the types of tools needed to obtain end-user feedback.
Cortical Source Estimate of Combined High Resolution EEG and fMRI Data Related to Voluntary Movements
Authors: Babiloni C. , Carducci F. , Gratta Del , Romani G. L. , Rossini P. M. , Cincotti F. , Babiloni F. 
Published: March 2018

Summary
Objectives: In this paper, we employed advanced methods for the modeling of human cortical activity related to voluntary right one-digit movements from combined high-resolution electroencephalography (EEG) and functional magnetic resonance imaging (fMRI).
Methods: Multimodal integration between EEG and fMRI data was performed by using realistic head models, a large number of scalp electrodes (128) and the estimation of current density strengths by linear inverse estimation.
Results: Increasing of spatial details of the estimated cortical density distributions has been detected by using the proposed integration method with respect to the estimation using EEG data alone.
Conclusion: The proposed method of multimodal EEG-fMRI data is useful to increase spatial resolution of movement-related potentials and can also be applied to other kinds of event-related potentials.
Medical Informatics: Between Science and Engineering, Between Academia and Industry
Authors: Shahar Y. 
Published: March 2018

Summary
Objective: To analyze the nature and appropriate role of the Medical Informatics research and practice area in the 21st Century, and to determine its links to academic environments versus industrial companies and health-care organizations.
Methods: A qualitative analysis of the state of the art of Medical Informatics, based on observation of current medical informatics programs and research in academic and industrial sites.
Results and Conclusions: Medical Informatics is definitely a scientific and technological area of endeavor, although somewhat ill-defined in scope. It is situated between science and engineering, but much closer to the engineering world, and its multidisciplinary nature fits well the engineering paradigm. It is better viewed as a specialization of the informatics field rather than as a basic medical science. However, there are good arguments as to why Medicine should be the first among equals to have its own informatics domain. Medical Informatics must have extensions to both academia and industry to survive. Medical informaticians, whether implicitly or explicitly, exist in three different environments: academic, clinical (user), and industrial (informatics developer); all three environments must be considered when trying to predict the future of this new multi-disciplinary area.
Knowledge Management to Support Performance-based Medicine
Authors: Stefanelli M. 
Published: March 2018

Summary
Objectives: To discuss research issues for medical informatics in order to support the further development of health information systems, exploiting knowledge management and information and communication technology to increase the performance of Health Care Organizations (HCOs).
Methods: Analyze the potential of exploiting knowledge management technology in medicine.
Results and conclusions: The increasing pressure on HCOs to ensure efficiency and cost-effectiveness, balance the quality of care, and contain costs will drive them towards more effective management of medical knowledge derived from biomedical research. Knowledge management technology may provide effective methods and tools in speeding up the diffusion of innovative medical procedures. Reviews of the effectiveness of various methods of best practice dissemination show that the greatest impact is achieved when such knowledge is made accessible through the health information system at the moment it is required by care providers at their work sites. There is a need to take a more clinical process view of health care delivery and to identify the appropriate organizational and information infrastructures to support medical work. Thus, the great challenge for medical informatics is represented by the effective exploitation of the astonishing capabilities of new technologies to assure the conditions of knowledge management and organizational learning within HCOs.
Person Identification from the EEG using Nonlinear Signal Classification
Authors: Rangoussi M. , Alexandris N. , Evangelou A. , Poulos M. 
Published: March 2018

Summary
Objectives: This paper focusses on the person identification problem based on features extracted from the ElectroEncephaloGram (EEG). A bilinear rather than a purely linear model is fitted on the EEG signal, prompted by the existence of non-linear components in the EEG signal – a conjecture already investigated in previous research works. The novelty of the present work lies in the comparison between the linear and the bilinear results, obtained from real field EEG data, aiming towards identification of healthy subjects rather than classification of pathological cases for diagnosis.
Methods: The EEG signal of a, in principle, healthy individual is processed via (non)linear (AR, bilinear) methods and classified by an artificial neural network classifier.
Results: Experiments performed on real field data show that utilization of the bilinear model parameters as features improves correct classification scores at the cost of increased complexity and computations. Results are seen to be statistically significant at the 99.5% level of significance, via the χ2 test for contingency.
Conclusions: The results obtained in the present study further corroborate existing research, which shows evidence that the EEG carries individual-specific information, and that it can be successfully exploited for purposes of person identification and authentication.
Medical Informatics as a Discipline at the Beginning of the 21st Century
Authors: Talmon J. L. , Hasman A. 
Published: March 2018

Summary
Objectives: To analyse the present situation of the discipline medical informatics and to propose actions for change.
Methods: Evaluation of the current situation mainly based on anecdotal evidence.
Results: The difference between the scientific and the engineering aspects of medical informatics get blurred. Because of the requirements of European funding medical informatics focuses more on engineering than on science. Too many manuscripts are submitted that describe engineered artefacts without a scientific purpose. Some of the subjects (like security issues) that are studied in medical informatics are not considered important by medical faculties thus impeding support.
Conclusions: The methodological underpinnings of our research should be strengthened, impact studies should be more frequently performed; the quality of results reporting should be increased.
Combining Medical Informatics and Bioinformatics toward Tools for Personalized Medicine
Authors: Simmons M. K. , Subramanian P. , Temkin J. M. , Sarachan B. D. 
Published: March 2018

Summary
Objectives: Key bioinformatics and medical informatics research areas need to be identified to advance knowledge and understanding of disease risk factors and molecular disease pathology in the 21st century toward new diagnoses, prognoses, and treatments. Methods: Three high-impact informatics areas are identified: predictive medicine (to identify significant correlations within clinical data using statistical and artificial intelligence methods), along with pathway informatics and cellular simulations (that combine biological knowledge with advanced informatics to elucidate molecular disease pathology).
Results: Initial predictive models have been developed for a pilot study in Huntington’s disease. An initial bioinformatics platform has been developed for the reconstruction and analysis of pathways, and work has begun on pathway simulation.
Conclusions: A bioinformatics research program has been established at GE Global Research Center as an important technology toward next generation medical diagnostics. We anticipate that 21st century medical research will be a combination of informatics tools with traditional biology wet lab research, and that this will translate to increased use of informatics techniques in the clinic.
Probabilistic Graphical Models for Computational Biomedicine
Authors: Antal P. , Fannes G. , De Moor B. , Moreau Y. 
Published: March 2018

Summary
Background: As genomics becomes increasingly relevant to medicine, medical informatics and bioinformatics are gradually converging into a larger field that we call computational biomedicine.
Objectives: Developing a computational framework that is common to the different disciplines that compose computational biomedicine will be a major enabler of the further development and integration of this research domain.
Methods: Probabilistic graphical models such as Hidden Markov Models, belief networks, and missing-data models together with computational methods such as dynamic programming, Expectation-Maximization, data-augmentation Gibbs sampling, and the Metropolis-Hastings algorithm provide the tools for an integrated probabilistic approach to computational biomedicine.
Results and Conclusions: We show how graphical models have already found a broad application in different fields composing computational biomedicine. We also indicate several challenges that lie at the interface between medical informatics, statistical genomics, and bioinformatics. We also argue that graphical models offer a unified framework making it possible to integrate in a statistically meaningful way multiple models ranging from the molecular level to cellular and to clinical levels. Because of their versatility and firm statistical underpinning, we assert that probabilistic graphical models can serve as the lingua franca for many computationally intensive approaches to biology and medicine. As such, graphical models should be a foundation of the curriculum of students in these fields. From such a foundation, students could then build towards specific computational methods in medical informatics, medical image analysis, statistical genetics, or bioinformatics while keeping the communication open between these areas.
Computational Integrative Physiology: At the Convergence of the Life and Computational Sciences
Authors: Julen N. , Sinteff J.-P. , Siregar P. 
Published: March 2018

Summary
Objective: In this paper we outline how Computational Integrative Physiology (CIP) can help unravel the mechanisms of normal and pathological biological processes. Our objective is to illustrate how CIP is firmly grounded on the life and computational sciences.
Method: After describing a general theoretical framework for CIP, we will center our discussion on cardiac rhythmic disorders with a particular focus on the Long QT syndrome that will serve as a case example. Within this context, we will describe multi-scale processes in biological, medical and in general mathematical terms, starting from the control of gene expression to the electrical activity of the entire heart. We will therefore proceed from the smaller microscopic scales to the larger macroscopic ones. In doing so, we will illustrate, at least in a qualitative sense, how CIP can be accomplished by showing some of the relations that can exist between mathematical variables characterizing models of different space-scales.
Conclusion: We will conclude by putting forth how CIP and the related fields of bioinformatics and medical informatics are necessary to derive meaningful knowledge from the huge and exponentially growing biological and medical data.
Medical Informatics and the Quality of Health: New Approaches to Support Patient Care
Authors: Haux R. , Kulikowski C. , Bohne A. , Brandner R. , Brigl B. , Fischer G. , Garde S. , Knaup P. , Ruderich F. , Schubert R. , Singer R. , Wolff A. C. , Ammenwerth E. 
Published: March 2018

Summary
Objectives: The Yearbook of Medical Informatics is published annually by the International Medical Informatics Association (IMIA) and contains a selection of excellent papers on medical informatics research which have been recently published (www.yearbook.uni-hd.de). The 2003 Yearbook of Medical Informatics took as its theme the role of medical informatics for the quality of health care. In this paper, we will discuss challenges for health care, and the lessons learned from editing IMIA Yearbook 2003.
Results and Conclusions: Modern information processing methodology and information and communication technology have strongly influenced our societies and health care. As a consequence of this, medical informatics as a discipline has taken a leading role in the further development of health care. This involves developing information systems that enhance opportunities for global access to health services and medical knowledge. Informatics methodology and technology will facilitate high quality of care in aging societies, and will decrease the possibilities of health care errors. It will also enable the dissemination of the latest medical and health information on the web to consumers and health care providers alike. The selected papers of the IMIA Yearbook 2003 present clear examples and future challenges, and they highlight how various sub-disciplines of medical informatics can contribute to this.
World-Wide Web-Based Graphical User Interfaces for Laboratory Data
Authors: Keller D. , Schaller W. J. , Wong J. S. K. , de Groen P. C. 
Published: March 2018

Summary
Objectives: Electronic medical record systems permit collection of large amounts of medical information. Usually, information is presented in a fixed format, either as text or tables. Health care providers have to navigate this fixed format in order to find information useful for a specific patient-provider interaction. The main objective of this work was to allow the provider immediate access to specific laboratory information through the development of a highly customizable, graphical user interface to the Mayo Clinic laboratory information system.
Methods – Results: Here we describe this platform-independent, World-Wide-Web-based graphical user interface that allows the provider to see all or a predetermined panel of essential laboratory data in graphical format. Advantages include availability at internet-based workstations, immediate recognition of trends over time, ability to zoom in and out of specific periods of time, and detailed analysis of patient values in relationship to normal values.
Conclusions: Web browser-based user interface allowing graphical display of laboratory data using Java technology was described. The connection to the Mayo Clinic laboratory information system combines cross-platform support for use on virtually any networked machine, interaction through a Web browser for ease of use, and a combination of the Perl and Java languages for powerful data processing and interactivity.
Developing a Public Key Infrastructure for a Secure Regional e-Health Environment
Authors: Mavridis I. , Ilioudis C. , Georgiadis C. , Pangalos G. 
Published: March 2018

Summary
Objectives: Internet technologies provide an attractive infrastructure for efficient and low cost communications in regional health information networks. The advantages provided by the Internet come however with a significantly greater element of risk to the confidentiality and integrity of information. This is because the Internet has been designed primarily to optimize information sharing and interoperability, not security. The main objective of this paper is to propose the exploitation of public-key cryptography techniques to provide adequate security to enable secure healthcare Internet applications.
Methods: Public-key cryptography techniques can provide the needed security infrastructure in regional health networks. In the regional health-care security framework presented in this paper, we propose the use of state-of-art Public Key Infrastructure (PKI) technology. Such an e-Health PKI consists of regional certification authorities that are implemented within the central hospitals of each region and provide their services to the rest of the healthcare establishments of the same region.
Results: Significant experience in this area has been gained from the implementation of the PKI@AUTH project.
Conclusions: The developed PKI infrastructure already successfully provides its security services to the AHEPA university hospital. The same infrastructure is designed to easily support a number of hospitals participating in a regional health information network.
User Friendliness Aspects of Home Care Telematics
Authors: Mantzouranis E. C. 
Published: March 2018

Summary
Objectives: Asthma is the most common chronic childhood disease with a high number of admissions and emergency room visits in pediatric hospitals. Treatment of asthmatic patients is best done by asthma specialists and requires the chronic use of prophylactic medications, additional treatment for acute exacerbations and regular check-ups. In Crete, a Greek island, there are many children with asthma who are not receiving care by an asthma specialist. The only specialty clinic for asthmatic children in Crete is in Heraklion, a city in the center of the island. We attempted to use telemedicine in order to reach and follow children with asthma who live in distant areas in Crete.
Methods: We set up a pilot telemedicine program with 10 asthmatic children already followed at the Specialty Clinic. Using teleconferencing techniques, we were able to obtain the medical history, examine the patients, educate them about the disease and adjust the treatment.
Results: The parents of patients accepted the tele-medicine service with a percentage of 90% and showed a special interest in this new service.
Conclusions: We conclude that telemedicine for asthmatic children performed by their specialist is feasible and accepted by the majority of patients.