bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modelling In-Patient Bed Usage Behaviour in a Department of Geriatric Medicine
Authors: Millard P. , McClean S. 
Published: March 2018

Abstract:The flow of patients through geriatric hospitals has been previously described in terms of acute and long-stay states where the bed occupancy at a census point is modelled by a mixed exponential model. Using data for sixteen years the model was fitted to successive annual census points, in order to provide a description of temporal trends. While the number of acute patients has remained fairly stable during the period, the model shows that there has been a decrease in the number of long-stay patients. Mean lengths of stay in our geriatric hospital before death or discharge have decreased during the study period for both acute and long-stay patients.Using these fits of the mixed exponential model to census data, a method is provided for predicting future turnover of patients. These predictions are reasonably good, except when the turnover patterns go through a period of flux in which assumption of stability no longer holds. Overall, a methodology is presented which relates census analysis to the behaviour of admission cohorts, thus producing a means of predicting future behaviour of patients and identifying where there is a change in patterns.
Semantic Analysis of Medical Records
Authors: Bassøe C.-F. , Rasmussen J.-E. 
Published: March 2018

Abstract:A program (LogStory) is described that was developed for the automatic semantic analysis of clinical narratives, stored in a computerized problem-oriented medical record (PROMED). The diagnoses were written in a free-text format during consultation, and later collected into diagnostic classes, e.g., diseases. A lexical parser automatically created dictionaries from the clinical narrative associated with each disease. Automatic (fuzzy) set operations were performed on the words associated with each class. The manifestations of 16 diseases were automatically extracted by pairwise operations on the word sets. The correlation between diseases and corresponding signs, symptoms and treatment was highly significant (p <0.001). Applying the difference operation on diseases with disjunct sets of clinical findings allowed the recovery of disease-specific knowledge. The evolution of a disease was accounted for, and the system was able to generalize its findings. The PROMED-LogStory concept enables the processing of natural language and may be a powerful tool for knowledge acquisition and clinical research.
The Development and Practical Use of Information Systems in the Pharmaceutical Industry
Authors: Negi H. , Tamura M. , Kawai T. , Yoda I. , Kawasaki T. , Hirata T. , Sugimura Y. , Okada S. , Yamamoto M. 
Published: March 2018

AbstractTo provide information on the efficacy, safety, and quality of medicine promptly and accurately, we have developed two databases: a literature database with numerical data, and a Drug Information database. By an easy-to-use, company-wide information network system, over 1,000 medical representatives in more than 80 offices throughout Japan can retrieve information. Information derived from the system is displayed on the terminal and the original documents are automatically output through a facsimile.
A Physician-Based Architecture for the Construction and Use of Statistical Models
Authors: Shachter R. D. , Lehmann H. P. 
Published: March 2018

Abstract:Physicians need specially tailored computer tools to take advantage of published research results. We present a knowledge-based computer framework -the physician-based (PB) architecture - for constructing such tools, and we use the problem of physicians’ interpretation of two-arm parallel randomized clinical trials (TAPRCT) as a working example. Statistical models are represented by influence diagrams. The interpretation of influence-diagram elements are mapped into users’ language in a domain-specific, physician-based user interface, called a patient-flow diagram. Statistical-model transformations that maintain the semantic relationships of the model and that embody clinical-epidemiological knowledge are encoded in a mediating structure called the cohort-state diagram. The algorithm that coordinates the interactions among the knowledge representations uses modular actions called construction steps. This architecture has been implemented in a Bayesian system, called THOMAS, that supports physician decision making in light of TAPRCT data. This support entails assessing clinical significance, prior beliefs, and methodological concerns. We suggest that the PB architecture applies to a wide range of statistical tools and users.
Application of Capture-Recapture Methods for Disease Monitoring: Potential Effects of Imperfect Record Linkage
Authors: Brenner H. 
Published: March 2018

Abstract:Capture-recapture methods are increasingly employed to correct for underascertainment of cases in disease monitoring. Routine systems of disease monitoring, such as morbidity registries, are often prone to specific threats of validity, such as in imperfect diagnoses or imperfect record linkage. A quantitative assessment is given of the performance of the two-source capture-recapture method for disease monitoring in the presence of imperfect record linkage. The capture-recapture approach can eliminate underestimation of the number of eligible cases, which is typical for most disease monitoring systems, under certain conditions, including independence of sources of case ascertainment and perfect record linkage. Correction for underestimation remains less than perfect, however, in the case of false-positive matches, whereas application of capture-recapture methods leads to overestimation of case numbers in the presence of false-negative matches. A simple correction procedure to overcome potential overestimation by false-negative matches is outlined.
Therapie von Erkrankungen der neuromuskulären Endplatte im Kindesund Jugendalter
Authors: Marina A. , Schara U. 
Published: March 2018

ZusammenfassungDie Erkrankungen der neuromuskulären Endplatte im Kindes- und Jugendalter umfassen die juvenile autoimunvermittelte Myasthenia gravis und die kongenitalen myasthenen Syndrome. Die autoimmune kindliche und juvenile Myasthenia gravis (JMB) ist definiert mit dem Auftreten der ersten Symptome vor dem 19. Lebensjahr, Häufigkeit ist nicht genau bekannt, sie macht ca. 10–15% der Myasthenien aus. Die Symptomatik ist variabel. Wichtig für eine zeitnahe Einleitung der Therapie ist die frühestmögliche Diagnosestellung. Deswegen ist es wichtig, auf initiale Symptome zu achten, um diese in die Verdachtsdiagnose einordnen zu können. Im Gegensatz zu der antikörpervermittelten autoimmunjuvenilen Myasthenia gravis handelt es sich bei den kongenitalen myasthenen Syndromen um eine genetisch bedingte und klinisch heterogene Gruppe von Erkrankungen, die als Folge eine Störung der Struktur und der Funktion der muskulären Endplatte haben. Auch bei dieser Krankheitsgruppe ist eine frühestmögliche Diagnose mit Einleitung einer entsprechenden Therapie für den optimierten Ausgang notwendig.In dieser Übersicht sollen die Leitsymptome, die möglichen und notwendigen Schritte der Diagnostik sowie die dann einzuleitende Therapie der unterschiedlichen Krankheitsbilder dargestellt werden.
Palliativtherapie neuromuskulärer Erkrankungen
Authors: Lorenzl S. , Reilich P. 
Published: March 2018

ZusammenfassungDie palliativmedizinischen und hospizlichen Versorgungsstrukturen und Angeboten wurden in den vergangenen Jahren in Deutschland stark ausgebaut. Dem klinisch tätigen Neurologen steht ein weites Spektrum an palliativmedizinischen Maßnahmen zur Verfügung. In dieser Arbeit wollen wir eine Übersicht über die Therapiemöglichkeiten der wichtigsten Symptome in der letzten Lebensphase am Beispiel von Patienten mit amyotropher Lateralsklerose (ALS) stellvertretend für Menschen mit neuromuskulären Erkrankungen geben und uns an den internationalen Empfehlungen der European Academy of Neurology sowie der nationalen S3-Leitlinie “Palliativmedizin” aus dem onkologischen Leitlinienprogramm orientieren.
On Analysis of Two-Way Contingency Tables with some Sampling Zero Cell Counts — Application to Human Reproduction Wastage according to Age —
Authors: Moussa M. A. A. 
Published: March 2018

A systematic procedure is described for the analysis of I x J cross-classifications with some nonstructural zeros. This includes (1) use of pseudo-Bayes estimators to remove zeros (2) fitting the smoothed array to all possible configurations of the log-linear models (3) fitting the data to the quasi -independence model after omitting counts of some anomalous cells — on the basis of standardized residuals to detect the cause of deviation from the null independence model. As a guide, a risk function value is computed for each array of smoothed pseudo-Bayesian estimates.Real-life data (based on a sampling survey conducted on the population of female nurses in Kuwait) is used for illustration.
Economic Evaluation of Effectiveness in Health Care Delivery
Authors: Gottinger H. W. 
Published: March 2018

This work focusses on two major aspects of public decision-making and policy analysis. First, to present a set-up for multi-criteria decision analysis (under certainty) based on interactive soul searching between the decision maker and the decision analyst (consultant) in which the decision maker repeatedly reveals his value judgement on a number of conflicting objectives and organizes his choice process in an adaptive fashion.Second, to show the usefulness of this kind of approach for practical decision-making and resource planning. Multi-criteria decision analysis has found applications in diverse fields, related to public policy decisions. But this work is probably the first comprehensive attempt to apply multi-criteria decision analysis to the choice of modes of health care delivery as a public decision problem.
Knowledge and Skills Expected of Health Information Scientists: A Sample Survey of Prospective Employers
Authors: Protti D. J. 
Published: March 2018

SummaryPotential employers of future health informatics graduates were surveyed as to their view of what informatics knowledge and skills were required to contribute to their organizations. 84 respondents clearly indicated that the most important of six areas of knowledge and skills was communications skills, followed by informatics knowledge, management knowledge, informa tics skills, analytic skills, and health services knowledge. The survey also revealed that the ranking of the six areas was the same for differing organizations and differing respondent groupings.
On the Analysis of Three-Dimensional Contingency Tables-Application to the Influence of Allergy and Age on Cancer
Authors: Moussa M. A. A. , Karnik A. M. , Omar Y. T. , Fenech F. F. 
Published: March 2018

SummaryA procedure is described for the analysis of I × J × K cross-classifications. This includes 1. selecting the appropriate model by iterative proportional fitting of the data to relevant configurations of log-linear models; 2. assumptions underlying reduction of three-way tables to two dimensions; 3. the Mantel-Haenszel statistic with reference to its relation to log-linear models.The methods are applied to a data set based on a study recently conducted at the Cancer Control Centre, Kuwait to investigate the relation between allergy and cancer. It was concluded that the allergy rate is significantly lower in the cancer group which suggests that allergy could be a protective factor against cancer.
The Use of a Personal Computer in the Pulmonary Function Tests of Laboratory Rats
Authors: Massad E. , Furuie S. Sh. , de Assis Moura L. , Nascimento Saldiva P. H. , Nicolelis M. A. , Böhm G. M. 
Published: March 2018

SummaryA system consisting of an 8-bit word microcomputer of the APPLE line equipped with an analog-to-digital converter, connected to a physiograph measuring pressures from a whole-body Plethysmograph, was used to perform pulmonary tests in rats. The system proved to be time-saving without loss in accuracy when compared to manual calculation methods. It allows measurement repetition during the same experiment, which is impossible by manual techniques, and permits to obtain flow/volume relationships without pneumotachographs or integrator and/or differentiator modules. This approach may be applied to humans and used by any physician.
A Computer-Assisted Register and Information System for Diabetes
Authors: Peacock I. , Jones R. B. , Hedley A. J. , Allison S. P. , Tattersall R. B. 
Published: March 2018

A new computer-assisted follow-up register and information system has been developed for patients with diabetes. The task of collecting and coding clinical information has been simplified, and methods of working in clinics have been adjusted to fit closely with the design of the new system.A flexible program suite includes statistical programs which allow clinical audit and evaluation of long term care to be carried out on demand. The system, which is on-line, operates under DSM 11 (DEC MUMPS) on a PDP 11/44 computer and, for hospital work, includes a video display unit and printer in the outpatient clinic and hospital ward.Registration of patients in the system may be carried out from either a hospital clinic or general practice. The clinical data base, completed at registration or review for each patient, is used to generate three computer-printed structured medical records .for use by hospitals, general practitioners and patients.The system can be used to provide (a) more reliable and effective record-keeping for patients and doctors, (b) automatic clinical audit for individuals or groups of patients, (c) data for long-term evaluation of care and other clinical research.
Effects of Prevalence and Test Diagnosticity upon Clinical Judgments of Probability
Authors: Balla J. I. , Elstein A. , Gates P. 
Published: March 2018

The process of revising diagnostic probabilities was studied to examine the relative influence of prior probability and test diagnosticity at various levels of clinical experience. The aims were to show changes with increasing seniority, to explore the effects of perceived seriousness of a disease, and to demonstrate systematic biases in handling probabilistic information. To these ends, 4 case vignettes were presented to 169 medical students in the three final years of the medical course and 25 residents. The data presented included the prior probabilities of two diseases and the true positive fraction of a single clinical manifestation of the rarer disease.Results showed a slightly increasing reliance on prior probability with increasing experience. The less experienced seemed most influenced by test results and by perceived seriousness of the disease. In some vignettes judgment seemed to depend on representativeness. In others, the most plausible explanation of the diagnostic choice would have been availability. Marked case-to-case variation was noted for individuals and there was a general lack of systematic biases. Revision of diagnostic opinion often depended on preconceived notions, and prior probabilities tended to be ignored. These are clear indications for teaching the basics of decision theory to medical students and early post-graduates.
Microcomputers for Field Studies in Epidemiology: An Experience in Southern Italy
Authors: Bouckaert A. , Lechat M. F. , De bruycker M. , Kettenis Y. , Speeckaert C. 
Published: March 2018

Microcomputers have been used for data entry, updating and checking during a field survey of health conditions after earthquake in Southern Italy.Although the basic procedure of interview and processing is the same as with conventional paper archives, benefits were seen to result from local statistical processing, fastness of file construction, monitoring of the quality of information collection. Local temperature and electricity distribution are clearly a problem. The need for a general software framework that can be adapted to several epidemiological surveys is emphasized.
Graphical Access to Medical Expert Systems: I. Design of a Knowledge Engineer’s Interface
Authors: Shortliffe E.H. , Tsuji S. 
Published: March 2018

SummaryOptimal construction of medical expert systems demands a powerful interactive environment for knowledge base management by knowledge engineers. Key requirements include techniques for (a) examining existing information, (b) adding new knowledge and editing preexisting data structures, and (c) examining dynamic internal system behavior to facilitate debugging during consideration of actual cases. This article addresses design considerations in the development of such knowledge engineering tools. The emphasis is on the use of professional workstations with high density graphics interfaces since that technology is rapidly becoming a predominant environment for knowledge engineering activities. To illustrate the points made, examples are drawn from an experimental knowledge base management tool designed for knowledge engineers constructing the knowledge base of ONCOCIN, an expert system to advise in the management of cancer patients.
Graphical Access to Medical Expert Systems: II. Design of an Interface for Physicians
Authors: Lane C. D. , Walton Joan , Shortliffe E. H. 
Published: March 2018

SummaryThe ONCOCIN Interviewer program provides a graphical interface between physicians and an expert system that is designed to assist with therapy selection for patients receiving experimental cancer therapy. A principal goal has been to increase acceptance of advanced computer tools in a clinical setting. The interface has been developed for high-performance Lisp workstations and is tailored to the existing paper forms and practices of the outpatient clinic. To be flexible, the program makes use of a document formatting language to control a raster graphics display of medical forms, traditional paper versions of which have been used to track patient progress. The program utilizes a mouse input device coupled with a software-defined data entry approach that may be customized to the specific environment. The work described suggests ways in which high density graphics interfaces, with pointing devices rather than an emphasis on keyboards, may make decision support tools more useful to physicians and more acceptable to them.
Registration of Diagnoses in the Danish National Registry of Patients
Authors: Jürgensen H. J. , Frølund C. , Gustafsen J. , Mosbech H. , Guldhammer Birgitte , Mosbech J. 
Published: March 2018

SummaryThe data recorded in the National Registry of Hospitalized Patients in Denmark (Landspatient-registeret [LPR]) are based on reports from the somatic departments of hospitals throughout the country. For the purpose of evaluating the quality of these data, information from LPR concerning patient diagnoses was compared with corresponding information in the records from 924 consecutive admissions to the Frederiksborg County Hospital, Hiller0d. The diagnoses in these records were registered and given priority based on predetermined criteria for selection of primary and secondary diagnoses, respectively. For each hospitalized case a total of 4 primary and 4 secondary diagnoses might be registered. In order to show the variation in choice of diagnoses between physicians, all records from the two medical departments and 10% from the remaining departments were revised by two different physicians. In the medical “block” (medical departments B and F, and the departments of physical medicine, paediatrics, and neurology), there was agreement between the two physicians on at least one of the maximally 4 primary diagnoses which could be registered in 92% of the cases (2-digit code). For the surgical “block” (the departments of parenchymal surgery, orthopaedic surgery, gynaecology, and otology), the corresponding figure was 95%. If the two coders were in agreement on at least one primary diagnosis, this was identical with LPR’s primary diagnosis in 76% of the cases in the medical “block” and 85% of the cases in the surgical “block” (2-digit code). However, in the case of 15% of the medical and 7% of the surgical cases, the primary diagnosis, on which the two coders were in agreement, was not recorded at all by LPR (3-digit code).It is to be emphasized that a certain variation between different physicians in their choice of diagnoses cannot be eliminated. In conclusion, the level of agreement between LPR and the study material found in the present study is in general satisfactory if LPR’s function as a basis of information for policy making in the hospital sector is taken into consideration. On the other hand, agreement (especially on medical records) is presumably not good enough in LPR to be used for research purposes.
A Graphic Method of Estimating the Specificity of Screening Programmes from Incomplete Follow-up Data
Authors: Brecht J. G. , Robra B.-P. 
Published: March 2018

SummaryThe specificity of a screening test determines, on the one hand, the extent of inconvenience and risk involved for healthy participants of a screening programme. This is, therefore, a possible determinant of programme acceptance. On the other hand, follow-up costs generally represent a considerable proportion of the total screening programme cost and are determined by the specificity. The specificity is thus an essential determinant of the efficiency of such a programme.Under the rare disease assumption it is possible to assess the specificity of screening programmes from cross-sectional data. On the basis of this method, a simple graphic way of evaluating the specificity is also described and illustrated by data stratified by age and screening history from the German National Cancer Screening Programme.
HAZARD: An Expert System for Risk Assessment of Environmental Chemicals
Authors: Gottinger H. W. 
Published: March 2018

AbstractThe purpose of this paper is to report on an expert system in design that screens for potential hazards from environmental chemicals on the basis of structure-activity relationships in the study of chemical carcinogenesis, particularly with respect to analyzing the current state of known structural information about chemical carcinogens and predicting the possible carcinogenicity of untested chemicals. The structure-activity tree serves as an index of known chemical structure features associated with carcinogenic activity. The basic units of the tree are the principal recognized classes of chemical carcinogens that are subdivided into subclasses known as nodes according to specific structural features that may reflect differences in carcinogenic potential among chemicals in the class. An analysis of a computerized data base of known carcinogens (knowledge base) is proposed using the structure-activity tree in order to test the validity of the tree as a classification scheme (inference engine).