bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cooperative Knowledge Evolution: A Construction-Integration Approach to Knowledge Discovery in Medicine
Authors: Tschaitschian B. , Schmalhofer F. J. 
Published: March 2018

AbstractIn this paper, we perform a cognitive analysis of knowledge discovery processes. As a result of this analysis, the construction-integration theory is proposed as a general framework for developing cooperative knowledge evolution systems. We thus suggest that for the acquisition of new domain knowledge in medicine, one should first construct pluralistic views on a given topic which may contain inconsistencies as well as redundancies. Only thereafter does this knowledge become consolidated into a situation-specific circumscription and the early inconsistencies become eliminated. As a proof for the viability of such knowledge acquisition processes in medicine, we present the IDEAS system, which can be used for the intelligent documentation of adverse events in clinical studies. This system provides a better documentation of the side-effects of medical drugs. Thereby, knowledge evolution occurs by achieving consistent explanations in increasingly larger contexts (i.e., more cases and more pharmaceutical substrates). Finally, it is shown how prototypes, model-based approaches and cooperative knowledge evolution systems can be distinguished as different classes of knowledge-based systems.
Three Types of IS-A Statement in Diagnostic Classifications: Three Types of Knowledge Needed for Development and Maintenance
Authors: Flier F. J. , de Vries Robbé P. F. , Zanstra P. E. 
Published: March 2018

AbstractUpdate mechanisms for diagnostic classifications should capture changes in medical knowledge but also allow for comparability across versions. This paper provides a basis for such a mechanism by describing types of IS-A statement and types of knowledge used in the construction of diagnostic classifications. Three types of IS-A statement are used: ‘A is by definition a 8’, ‘A is probably a 8’ and ‘A is in theory necessarily a 8’. Each relates to a different type of knowedge: knowledge of linguistic conventions, of probabilities, and of empirical theories and their status, respectively. Consequently, the development and maintenance of diagnostic classifications requires a collaboration of medical terminologists and medical scientists. The role of the latter is especially important during updating. Updating is necessitated by changing probabilities and by the introduction or changing status of empirical theories. The linguistic notion of hyponymy oversimplifies the issue.
The SNOMED DICOM Microglossary: Controlled Terminology Resource for Data Interchange in Biomedical Imaging
Authors: Dean Bidgood W. 
Published: March 2018

AbstractThis paper describes an authoritative, non-proprietary information resource that provides an efficient mechanism for embedding specialized clinical knowledge into the design of healthcare telecommunications systems. The resource marries two types of data interchange standards, a message/electronic-document standard and a terminology standard. In technical terms, it is part protocol and part database. Industry, academia, professional specialty societies, and the federal government participated in its development. The development of mUlti-specialty content has broadly engaged biomedical domain experts to an unprecedented degree in voluntary, non-proprietary message/document-standards development. The resource is the SNOMED DICOM Microglossary (SDM) [1], a message-terminology (or document-content) mapping resource. The message/electronicdocument standard is DICOM (Digital Imaging and Communications in Medicine) [2]. The terminology standard is SNOMED, (Systematized Nomenclature of Human and Veterinary Medicine) [31. The SDM specifies the mapping of multi-specialty imaging terminology from SNOMED to DICOM data elements. DICOM provides semantic constraints and a framework for discou rse that are lacking in SNOMED. Thus the message standard and the computerbased terminology both depend upon and complete each other. The combination is synergistic. By substitution of different templates of specialty terminology from the SDM, a generic message template, such as the DICOM Visible Light (Color Diagnostic) Image or the DICOM Structured Reporting specification can be reconfigured for diverse applications. Professional societies, with technical assistance from the College of American Pathologists, contribute and maintain their portions of the terminology, and can use SDM templates and term lists in clinical practice guidelines for the structure and content of computer-based patient records.
Metaphrase: An Aid to the Clinical Conceptualization and Formalization of Patient Problems in Healthcare Enterprises
Authors: Olson N. E. , Keck K. D. , Cole W. G. , Erlbaum M. S. , Sherertz D. D. , Chute C. G. , Elkin P. L. , Atkin G. E. , Kaihoi B. H. , Safran C. , Rind D. , Law V. , Tuttle M. S. 
Published: March 2018

AbstractPatient descriptors, or “problems,” such as “brain metastases of melanoma” are an effective way for caregivers to describe patients. But most problems, e.g., “cubital tunnel syndrome” or “ulnar nerve compression,” found in problem lists in an Electronic Medical Record (EMR) are not comparable computationally – in general, a computer cannot determine whether they describe the same or a related problem, or whether the user would have preferred “ulnar nerve compression syndrome.” Metaphrase is a scalable, middleware component designed to be accessed from problemmanager applications in EMR systems. In response to caregivers' informal descriptors it suggests potentially equivalent, authoritative, and more formally comparable descriptors. Metaphrase contains a clinical subset of the 1997 UMLS Metathesaurus and some 10,000 “problems” from the Mayo Clinic and Harvard Beth Israel Hospital. Word and term completion, spelling correction, and semantic navigation, all combine to ease the burden of problem conceptualization, entry and formalization.
The Nature of Lexical Knowledge
Authors: McCray A. T. 
Published: March 2018

AbstractThis paper considers the nature of lexical knowledge and its role in language and information processing. The lexicon is the central component of language and plays a pivotal role in current linguistic theory [3, 4] and, increasingly, in natural language processing systems [5-7]. The lexicon embodies information aboutthe lexical items ofthe language and serves as the foundation for morphologic, syntactic, and semantic processing. The differences as well as commonalities among dictionaries, thesauri, and lexicons are discussed, and distinctions between words, lexical items, and terms are drawn. Next, the scope and content ofthe SPECIALIST lexicon are presented, followed by a discussion of certain writing conventions that can be troublesome for text processing applications. One approach to handling orthographic and other lexical variation is discussed in a section that reports on the design and implementation of the SPECIALIST lexical programs. The paper concludes with a discussion of controlled terminologies for the medical domain. Throughout the discussion, examples are drawn from the SPECIALIST lexicon and from the other UMLS knowledge sources [8,9].
A Quantitative Ranking of the Biomedical Informatics Serials
Authors: Kaalaas-Sittig J. , Sittig D. F. 
Published: March 2018

Abstract:We have developed a quantitative serial ranking system based on multiple citation analysis techniques, library use statistics, expert opinion, and selected distinguishing publication characteristics. Evaluation criteria categories include: average Science Citation Index (Impact Factor, Immediacy Index, Total citations) rankings from 1987 to 1992; citation source counts of multiple “core” biomedical informatics publications; a questionnaire sent to American College of Medical Informatics Fellows; publication delay; distinguishing characteristics (e. g., subscription cost, total circulation, year established, places indexed, affiliation with a professional society, major biomedical resource library holdings); and the total number of interlibrary loan requests to the U. S. National Library of Medicine. The top serials were Computers and Biomedical Research, MD Computing, Methods of Information in Medicine, Medical Decision Making and Computers in Biology and Medicine.
Experiences Using New Zealand’s Hospital Based Surveillance System for Injury Prevention Research
Authors: Langley J. D. 
Published: March 2018

Abstract:The focus of this paper is the Injury Prevention Research Unit’s (IPRU’s) experience in analysing New Zealand’s national inpatient public hospital injury data set. The existence of the national inpatient data management system has enabled the IPRU to develop an injury morbidity data set for the period of 1979-1992. The IPRU, thus, has data on over 250,000 injury events that were serious enough to warrant admission to a hospital. This data set has been used extensively by the IPRU to address a wide range of injury issues from demographic, environment, activity, product, and injury perspectives. Apart from the demographic variables, those variables that have proved most useful in our work have been: length of stay, readmission indicator, a personal identifier code number, WHO International Classification of Disease coding for diagnoses and external cause of injury (E-code), and written descriptions of external cause of injuries and location of injury event. Practical examples of IPRU’s use of each of these variables are given. These examples demonstrate how invaluable New Zealand’s inpatient injury data set is for documenting resource utilisation, accurately determining the incidence of events, undertaking analytical epidemiological studies including evaluations, and addressing shortcomings in E-codes. A key aspect of the system is the narrative information. Evidence is produced demonstrates that the electronic recording of narratives of the circumstances of injury is an invaluable tool for conducting epidemiological research which has direct implications for injury prevention policy and practice. Given the numerous objections that are raised about E-coding, injury prevention personnel would be well served to encourage health authorities to electronically record narratives as a first step towards uniform coding.
A Computerised Implementation of a Minimum Set of Health Indicators
Authors: Blignaut P. J. , McDonald T. 
Published: March 2018

Abstract:Three alternative approaches to computerise primary health care services as provided in clinics in South Africa are compared. The first approach implements a system based on a head-count approach using a minimum set of indicators. This system resembles the current manual system of tally sheets. The second and third approaches implement computer systems based on patient records. The second approach is based on a very limited data set, and the third utilizes a comprehensive demographic and clinical data set. The three alternatives are compared with regard to practicality, flexibility, ease of use, accuracy and completeness of statistical reports, and time utilisation. It is concluded that the flexibility of a patientrecord approach, although more time consuming, is preferred. The second alternative is more feasible in a developing country with mostly computerilliterate nurses. Ways in which such a system can be implemented in an environment with limited hardware resources are also proposed.
Development of a Primary Health Care Information System in Ghana: Lessons Learned
Authors: Campbell B. C. , Heywood A. B. 
Published: March 2018

Abstract:In Ghana, between January 1990 and September 1993, a series of steps were undertaken to review the existing vertical reporting procedures and to develop an integrated Health Management Information System (HMIS) for Primary Health Care (PHC).These steps included a situation analysis of the existing reporting systems; participatory design of tools for planning, data collection, feedback and reporting; field test and revision of the modified system; training of staff at all levels; development of tools for self-assessment and stimulation of routine feedback to lower levels and reporting of analysed indicators to higher levels.There were some notable achievements which included promotion of self-reliance, improved data relevance and accuracy, as well as strengthened supervision and support. However, it was difficult to identify the most appropriate institutional location for the HMIS; over-emphasis on process leads to reduced implementation; reporting was still given greater priority than analysis and use of data, and systems for collection and use were still cumbersome and time consuming. It is also difficult to prove that having better information really improves decision-making, or even coverage and quality of PHC service delivery.These issues, as well as lessons learned, are discussed in the paper.
Development of an HIV Clinical and Research Database for South Africa
Authors: Spencer D. C. , Steinberg M. H. , Kanter A. S. 
Published: March 2018

Abstract:Health service restructuring in South Africa provides an opportunity to introduce appropriate Health Information System (HIS) technology. This is particularly relevant given the emerging HIV epidemic and the need to capture, translate and disseminate new experiences in HIV/AIDS care, support and clinical research. In 1994, a number of clinicians and health-care providers working in South Africa had begun to establish basic computerized databases to assist in research on HIV, but no standardized nomenclature or framework for collaboration was created. This paper describes a clinical and research database that could be used as an example for a standardized system by clinicians working in South Africa. The authors, with assistance from the National AIDS Research Programme of the Medical Research Council, created a prototype relational database using Microsoft Access™. To test the prototype, 1057 HIV-positive patients from the Infectious Disease Clinic at Johannesburg General Hospital were entered.
Fault Diagnosis in an Expert System for Health Services Management in the Tropics
Authors: Asoh D. A. , Boyom S. F. , Kwankam S. Y. 
Published: March 2018

Abstract:An integrated large-scale expert system called Health-2000, for the management of health services in regions where tropical diseases are endemic, has been designed. This system combines knowledge and databases, the contents of which are operated upon by an inference engine, to produce usable information. The system allows a host of applications, ranging from medical diagnosis to fault detection and preventive maintenance of biomedical equipment.The theoretical background and approach used in the development of the fault diagnosis and equipment maintenance sub-system of Health-2000 is presented. Model-based knowledge acquisition, and an extension of the Failure Modes, Effects and Criticality Analysis are two methodologies applied to build its knowledge bases. The inference engine which supports backward and forward chaining, operates on numerical and non-numerical facts, and uses fuzzy logic to handle vague and uncertain knowledge. Fault isolation proceeds in a top-down fashion, from equipment sub-system, to modules and components.
Health Informatics: Handle with Caution
Authors: Leroy V. , Maurice-Tison S. , Le Blanc B. , Salamon R. 
Published: March 2018

Abstract:The increased use of computers is a response to the considerable growth in information in all fields of activities. Related to this, in the field of medicine a new component appeared about 40 years ago: Medical Informatics. Its goals are to assist health care professionals in the choice of data to manage and in the choice of applications of such data. These possibilities for data management must be well understood and, related to this, two major dangers must be emphasized. One concerns data security, and the other concerns the processing of these data. This paper discusses these items and warns of the inappropriate use of medical informatics.
Health-2000: An Integrated Large-scale Expert System for the Hospital of the Future
Authors: Boyom S. F. , Asoh D. A. , Asaah C. , Kengne F. , Kwankam S. Y. 
Published: March 2018

Abstract:Decision making and management are problems which plague health systems in developing countries, particularly in Sub-Saharan Africa where there is significant waste of resources. The need goes beyond national health management information systems, to tools required in daily micromanagement of various components of the health system. This paper describes an integrated expert system, Health-2000, an information-oriented tool for acquiring, processing and disseminating medical knowledge, data and decisions in the hospital of the future. It integrates six essential features of the medical care environment: personnel management, patient management, medical diagnosis, laboratory management, propharmacy, and equipment management. Disease conditions covered are the major tropical diseases. An intelligent tutoring feature completes the package. Emphasis is placed on the graphical user interface to facilitate interactions between the user and the system, which is developed for PCs using Pascal, C, Clipper and Prolog.
National Health Management Information System: Issues of Funding and Support
Authors: Soriyan H. A. , Makanjuola R. O. A. , Akinde A. D. 
Published: March 2018

Abstract:Information Technology has made a substantial inroad into Nigerian society, particularly since the late 1980s. It is, however, already being applied in the health sector.The Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria has adopted a systematic approach to the development of a Health Information System (HIS) for a typical specialist hospital. A review of the existing HIS in OAUIHC is presented, highlighting its attributes, problems, and limitations. In addition, the options of funding HIS on a national scale are identified and discussed.Finally, strategies to ensure ongoing support of a national HIS are presented.
Detection of Aberrant Observations in a Background of an Unknown Multidimensional Gaussian Distribution
Authors: Gelsema E. S. , Leijnse B. , Wulkan R. W. 
Published: March 2018

AbstractAn exploratory iterative technique for the detection of aberrant observations on a background of a multidimensional Gaussian distribution is described. Its development was motivated by the analysis of a set of three measurements reflecting the acid-base metabolism in the blood of 2,402 intensive care patients. This new, three-dimensional treatment of such data yields a meaningful description. A technical evaluation of the method, using artificially generated data is also presented. It is shown that the model parameters of the underlying Gaussian distributions are determined with good accuracy and that the accuracy with which the contamination is estimated increases with increasing distance of the contaminating observations from the mean.
Methodology of ECG Interpretation in the Nagoya Program
Authors: Okamoto N. , Yokoi M. , Iwatsuka T. , Ohsawa N. , Okajima M. 
Published: March 2018

AbstractThe outline of the Nagoya Program, the most representative software package for computerized electrocardiography in Japan, is described. First, the history and current status of research and its transfer to commercial products for computerized interpretation of electrocardiograms is briefly reviewed. Second, development and testing of the Nagoya Program is depicted, referring to a gold standard for evaluation and the database being used for this purpose, and to its participation in the CSE study. Third, a description of signal acquisition and wave identification is given, followed by the detection of rhythm disturbances. Next, algorithms for contour classification, which consist of decision-tree logic established through trial and error and making use of the database of ECGs, are described. Finally, special features and future plans of the Nagoya Program are mentioned.
The Design and Management of National Morbidity Surveys
Authors: Fleming D. M. 
Published: March 2018

Abstract:This paper describes the three major morbidity surveys in general practice which have been conducted in England and Wales. In it, the evolution of the recording method is traced from the patient summary card of the first survey to the diagnostic index of the second and third surveys and finally, to the fully computerised recording programme to be used in the fourth survey due to start in September, 1991. Issues relating to the capture of social data, the use of diagnostic terms and the value of obtaining data over a 12 month period are discussed.
The octave approach to EEG analysis
Authors: Stassen H. H. 
Published: March 2018

Abstract:A “tonal” approach to EEG spectral analysis is presented which is compatible with the concept of physical octaves, thus providing a constant resolution of partial tones over the full frequency range inherent to human brain waves, rather than for equidistant frequency steps in the spectral domain. The specific advantages of the tonal approach, however, mainly pay off in the field of EEG sleep analysis where the interesting information is predominantly located in the lower octaves. In such cases the proposed method reveals a fine structure which displays regular maxima possessing typical properties of “overtones” within the three octaves 1-2 Hz, 2-4 Hz and 4-8 Hz. Accordingly, spectral patterns derived from tonal spectral analyses are particularly suited to measure the fine gradations of mutual differences between individual EEG sleep patterns and will therefore allow a more efficient investigation of the genetically determined proportion of sleep EEGs. On the other hand, we also tested the efficiency of tonal spectral analyses on the basis of our 5-year follow-up data of 30 healthy volunteers. It turned out that 28 persons (93.3%) could be uniquely recognized after five years by means of their EEG spectral patterns. Hence, tonal spectral analysis proved to be a powerful tool also in cases where the main EEG information is typically located in the medium octave 8-16 Hz.
A Framework for Modelling the Electronic Medical Record
Authors: Nowlan W. A. , Kay S. , Goble C. A. , Howkins T. J. , Rector A. L. 
Published: March 2018

Abstract:This paper presents a model for an electronic medical record which satisfies the requirements for a faithful and structured record of patient care set out in a previous paper in this series. The model underlies the PEN & PAD clinical workstation, and it provides for a permanent, completely attributable record of patient care and the process of medical decision making. The model separates the record into two levels: direct observations of the patient and meta-statements about the use of observations in decision making and the clinical dialogue. The model is presented in terms of “descriptions” formulated in the Structured Meta Knowledge (SMK) formalism, but many of its features are more general than the specific implementation. The use of electronic medical records based on the model for decision support and the analysis of aggregated data are discussed along with potential use of the model in distributed information systems.