bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extracting Findings from Narrative Reports: Software Transferability and Sources of Physician Disagreement
Authors: Kuperman G.J. , Friedman C. , Hripcsak G. 
Published: March 2018

Abstract:While natural language processing systems are beginning to see clinical use, it remains unclear whether they can be disseminated effectively through the health care community. MedLEE, a general-purpose natural language processor developed for Columbia-Presbyterian Medical Center, was compared to physicians' ability to detect seven clinical conditions in 200 Brigham and Women's Hospital chest radiograph reports. Using the system on the new institution's reports resulted in a small but measurable drop in performance (it was distinguishable from physicians at p = 0.011). By making adjustments to the interpretation of the processor's coded output (without changing the processor itself), local behavior was better accommodated, and performance improved so that it was indistinguishable from the physicians. Pairs of physicians disagreed on at least one condition for 22% of reports; the source of disagreement appeared to be interpretation of findings, gauging likelihood and degree of disease, and coding errors.
Indicators for the Automated Analysis of Drug Prescribing Quality
Authors: Séné B. , Milstein C. , Bouée S. , Venot A. , Coste J. 
Published: March 2018

Abstract:Irrational and inconsistent drug prescription has considerable impact on morbidity, mortality, health service utilization, and community burden. However, few studies have addressed the methodology of processing the information contained in these drug orders used to study the quality of drug prescriptions and prescriber behavior. We present a comprehensive set of quantitative indicators for the quality of drug prescriptions which can be derived from a drug order. These indicators were constructed using explicit a priori criteria which were previously validated on the basis of scientific data. Automatic computation is straightforward, using a relational database system, such that large sets of prescriptions can be processed with minimal human effort. We illustrate the feasibility and value of this approach by using a large set of 23,000 prescriptions for several diseases, selected from a nationally representative prescriptions database. Our study may result in direct and wide applications in the epidemiology of medical practice and in quality control procedures.
Towards the Unification of Inference Structures in Medical Diagnostic Tasks
Authors: Rives J. , Delgado A. E. , Martínez R. , Mira J. 
Published: March 2018

Abstract:The central purpose of artificial intelligence applied to medicine is to develop models for diagnosis and therapy planning at the knowledge level, in the Newell sense, and software environments to facilitate the reduction of these models to the symbol level. The usual methodology (KADS, CommonKADS, GAMES, HELIOS, Protégé, etc.) has been to develop libraries of generic tasks and resuable problem-solving methods with explicit ontologies. The principal problem which clinicians have with these methodological developments concerns the diversity and complexity of new terms whose meaning is not sufficiently clear, precise, unambiguous and consensual for them to be accessible in the daily clinical environment. As a contribution to the solution of this problem, we develop in this article the conjecture that one inference structure is enough to describe the set of analysis tasks associated with medical diagnoses. To this end, we first propose a modification of the systematic diagnostic inference scheme to obtain an analysis generic task and then compare it with the monitoring and the heuristic classification task inference schemes using as comparison criteria the compatibility of domain roles (data structures), the similarity in the inferences, and the commonality in the set of assumptions which underlie the functionally equivalent models. The equivalences proposed are illustrated with several examples. Note that though our ongoing work aims to simplify the methodology and to increase the precision of the terms used, the proposal presented here should be viewed more in the nature of a conjecture.
Conceptual Analysis for Knowledge-Base Design
Authors: Sowa J. F. 
Published: March 2018

Abstract:Knowledge-base design requires a thorough analysis of the concepts to be represented. If the analysis is incomplete or inaccurate, the resulting knowledge base may contain arbitrary restrictions, inconsistent data, or limitations that make future extensions impossible. Conceptual analysis is even more critical for sharing knowledge bases between heterogeneous systems. Analyses that are adequate for independent systems may cause incompatibilities when the systems share data. This paper discusses the kinds of problems that require a careful conceptual analysis and the difficulties caused by an incorrect or incomplete analysis. It also shows how independently developed knowledge bases can be related to one another by reanalyzing and redefining the basic concepts and relations. Such analysis is essential for sharing knowledge between systems developed for different purposes, such as relational and object-oriented databases or expert systems and natural language processors.
Development of a Controlled Medical Terminology: Knowledge Acquisition and Knowledge Representation
Authors: Musen M. A. , Wieckert K. E. , Miller E. T. , Campbell K. E. , Fagan L. M. 
Published: March 2018

Abstract:The creation of controlled medical terminologies is a central challenge in the development of electronic patient records. In the T-HELPER patient-record system, designed for the care of patients with HIV diease, the IVORY module allows health-care workers to compose textual progress notes by making selections from menus generated automatically from a controlled medical terminology. Construction of this IVORY terminology required extensive design sessions with a team of computer scientists and an expert physician. Refinement of the terminology was only possible when the design team could envision how the completed T-HELPER system would be used in the context of clinical practice. Development of controlled medical terminologies is a significant problem in knowledge acquisition. Techniques used to acquire and represent clinical concepts for the purpose of building decision-support systems also are appropriate for the construction of controlled terminologies such as the one in T-HELPER.
Navigating to Knowledge
Authors: Tuttle M. S. , Cole W. G. , Sherertz D. D. , Nelson S. J. 
Published: March 2018

Abstract:One way to fulfill point-of-care knowledge needs is to present caregivers with a visual representation of the available “answers”. Using such a representation, caregivers can recognize what they want, rather than have to recall what they need, and then navigate to an appropriate answer. Given selected pieces of information from a computer-based patient record, an interface can anticipate certain knowledge needs by initializing caregiver navigation in a semantic neighborhood of answers likely to be relevant to the patient at hand. These notions draw heavily on two collaborative projects – the U.S. National Library of Medicine Unified Medical Language System® and the U.S. National Cancer Institute Knowledge Server. Both of these projects support navigation because they make the structure of medical knowledge explicit in a way that can be exploited by human interfaces.
A Real Time Control Architecture for Continuously Managing Patients in a Care Unit
Authors: Seroussi B. , Boisvieux J. F. , Morice V. 
Published: March 2018

Abstract:The monitoring and treatment of patients in a care unit is a complex task in which even the most experienced clinicians can make errors. A hemato-oncology department in which patients undergo chemotherapy asked for a computerized system able to provide intelligent and continuous support in this task. One issue in building such a system is the definition of a control architecture able to manage, in real time, a treatment plan containing prescriptions and protocols in which temporal constraints are expressed in various ways, that is, which supervises the treatment, including controlling the timely execution of prescriptions and suggesting modifications to the plan according to the patient’s evolving condition. The system to solve these issues, called SEPIA, has to manage the dynamic, processes involved in patient care. Its role is to generate, in real time, commands for the patient’s care (execution of tests, administration of drugs) from a plan, and to monitor the patient’s state so that it may propose actions updating the plan. The necessity of an explicit time representation is shown. We propose using a linear time structure towards the past, with precise and absolute dates, open towards the future, and with imprecise and relative dates. Temporal relative scales are introduced to facilitate knowledge representation and access.
The Road to Professionalism in Medical Informatics: A Proposal for Debate
Authors: Wyatt J. , Heathfield H. A. 
Published: March 2018

Abstract:Medical Informatics has not as yet reached professional status. However, as an expanding and increasingly important discipline in the delivery of healthcare, it is important that it strives towards professionalisation. In this article we consider the nature of professionalism, its potential benefits and associated costs. We examine the potential for Medical Informatics to become a professional discipline and how far it has succeeded in this to date, describing three possible scenarios for the future of the discipline. We suggest steps towards the professionalisation of Medical Informatics and the roles of key players, including academia, system developers, purchasers and users, and professional societies. We also put forward some possible criteria for a Medical Informatics Professional. Finally, we make some general observations concerning the way forward.
Global Schistosomiasis Database: Practical Considerations in the Design of a User-friendly Database
Authors: Mort K. E. , Yoon S. S. 
Published: March 2018

AbstractA computerized database for monitoring global schistosomiasis data is discussed. The potential target users include schistosomiasis program managers, Ministries of Health of endemic countries, consultants, and WHO Regional Offices. The concept behind the design of the database structure, the user interface and the query interface is addressed along with a brief description of the hardware and software used. The database, holding information on 76 schistosomiasis endemic countries around the world, has been tested in the WHO Regional Offices with positive results.
Problem Area Formation as an Element of Computer Aided Diagnosis: A Comparison of Two Strategies Within Quick Medical Reference (QMR)
Authors: Berman L. , Miller R. A. 
Published: March 2018

AbstractINTERNIST-I’s use of “partitioning” to group related diagnoses into problem areas (for competitive consideration and elimination during case analysis) is felt to be the source of many of its strengths as well as some of its weaknesses. QMR, INTERNIST-I’s successor program, embodies a homology function which can act as an alternative to the partitioner for problem area formation. This study undertakes a comparison of the problem areas generated by the INTERNIST-I partitioning algorithm, the QMR homology function, and expert clinicians; it finds the correlation to be poor. The authors then discuss another method of problem area formation which might better mimic a human clinician and provide an alternative approach in diagnostic computer-aided decision making.
Robust Trend Analysis in Predicting Histamine Provocation Concentration
Authors: Krusińska E. , Liebhart J. , Woźniak M. 
Published: March 2018

AbstractTrend analysis is used to predict the histamine provocation concentration PC20 during the so-called challenge test, where increasing doses of the bronchoconstricting agent are given to a patient and the spirometric examination is subsequently performed. Classical least-squares analysis of trends as well as least absolute deviations analysis are compared. The results are interesting and promising from a statistical as well as medical point of view. The methods presented can be applied to many practical problems in medicine.
Structured Reporting of Medical Findings: Evaluation of a System in Gastroenterology
Authors: Gaus W. , Wechsler J. G. , Janowitz P. , Tudyka J. , Kratzer W. , Swobodnik W. , Ditschuneit H. , Kuhn K. 
Published: March 2018

Abstract:A system using structured reporting of findings was developed for the preparation of medical reports and for clinical documentation purposes in upper abdominal sonography, and evaluated in the course of routine use. The evaluation focussed on the following parameters: completeness and correctness of the entered data, the proportion of free text, the validity and objectivity of the documentation, user acceptance, and time required. The completeness in the case of two clinically relevant parameters could be compared with an already existing database containing freely dictated reports. The results confirmed the hypothesis that, for the description of results of a technical examination, structured data reporting is a viable alternative to free-text dictation. For the application evaluated, there is even evidence of the superiority of a structured approach. The system can be put to use in related areas of application.
The Role of Genetics in Defining Reference Values and Health Status
Authors: Siest G. , Zaiou M. , Régis A. , Jaid M. , Steinmetz J. , Herbeth B. , Artur Y. , Schiele F. , Gueguen R. , Galteau M. M. , Henny J. , Deschamps J. P. , Visvikis S. 
Published: March 2018

Abstract:Since its establishment, the Center for Preventive Medicine in Vandoeuvre-les-Nancy, France, performed specific studies on healthy humans, and its approach was very useful for defining reference values. Prevention should extend its interest to chronic diseases. The majority of important adult disorders are partially genetically determined. Genetic markers are also useful as exclusion or as partition criteria in the production of reference values. Results are presented that were obtained for apolipoproteins E, B and AIV, frequencies of these polymorphisms in the Lorraine population, and relationships between these polymorphisms and lipid metabolism-related parameters. Health checkup centers, in particular those involved in family screening, are well suited for reassembling many data concerning environmental factors: tobacco consumption, alimentation habits, or alcohol and drug consumption. Simultaneous determination of genetic markers could allow the determination of an individual’s susceptibility or resistance to developing a disease and to prepare a preventive action.
AR (q, v) Modeling of Normal Lung Sounds
Authors: Schreur H. J. W. , Vanderschoot J. 
Published: March 2018

Abstract:A model for the dependence of normal lung sounds upon airflow and air volume recorded at the mouth, is proposed and investigated. Data from 8 healthy subjects and 2 sessions have been analysed. Test statistics give very strong support for the adequacy of the model. This opens possibilities for diagnostic application of the model to normal lung sounds. Several suggestions are given for still further improvement of the model.
Interactions between Respiratory, Cardiac and Stepping Rhythms in Decerebrated Cats: Functional Hierarchical Structures of Biological Oscillators
Authors: Kawahara K. , Yamauchi Y. , Niizeki K. , Yoshioka T. 
Published: March 2018

Abstract:Interactions are described of central origin between respiratory, cardiac and stepping rhythms during fictive locomotion in paralyzed, vagotomized, and decerebrated cats. Fictive locomotion was induced by tonic electrical stimulation of the mesencephalic locomotor region (MLR). The coherence between heart beat fluctuation, the efferent discharges of the phrenic, and the lateral gastrocnemius nerves was used to evaluate the strength of the coupling between those three rhythms. The heart beat rhythm was modulated by the centrally generated respiratory and stepping rhythms. The central respiratory rhythm was modulated by the centrally generated stepping rhythm. Based on the present findings, we have proposed a new model concerning the functional hierarchical structures of the three biological oscillators.
Portable Cardiac Mapping Assessment of Acute Ischaemic Injury
Authors: Cullen C. , MacKenzie G. , Adgey A. A. J. , Anderson J. McC. , Dempsey G. J. , Wright G. T. H. , Crawley M. , McAdams E. T. , McLaughlin J. 
Published: March 2018

Abstract:A portable cardiac mapping system is used to improve the accuracy of diagnosis of acute ischaemic injury outside hospital. Patients presenting chest pain suggestive of myocardial infarction (Ml) were mapped by attendant medical personnel operating from a mobile coronary unit. These first Ml maps were compared against average normal maps using QRS and ST-T isointegral values. Discriminant function analysis performed on the parameters achieved a sensitivity of 90% and a specificity of 96%.
Time-Varying Properties of Respiratory Fluctuations in Pupil Diameter of Human Eyes
Authors: Yana K. , Okuyama F. , Tokoro Takashi , Yoshida H. 
Published: March 2018

Abstract:The time varying properties have been investigated of respiratory components in fluctuations of the pupil diameter (PDF) of the human eye. PDF and instantaneous lung volume were simultaneously measured for 45 minutes under natural binocular viewing conditions. The short-term Fourier transform and the autoregressive signal modeling together with the recursive least squares algorithm have been applied for the estimation of nonstationary power spectra. Data analysis showed a bursting type non-sta-tionarity in the appearance of the respiratory component in PDF.
Health Information Science at the University of Victoria: The First Ten Years
Authors: Protti D. J. 
Published: March 2018

Abstract:The University of Victoria has the only program in Canada offering a Bachelor of Science degree in Health Information Science. To meet the requirements of the degree, students must complete 40 courses and 4 CO-OP work terms over 4.3 years. The School admits 30 students each September of which 60% are normally female. Seventy-five percent of the students come from British Columbia, ranging in age from 18 to 42 with the average age being 26 years. In addition to recent high school graduates, over 40% have previous degrees or diplomas, and 65% have over 5 years of work experience. The School’s teaching team consists of 5 full-time faculty, 3 professional staff and 4 part-time faculty. The majority of the faculty have health backgrounds, totalling 135 person-years of practising health care experience. As of November 1992, the School had 113 graduates; 75% are employed in British Columbia, 18% are in other parts of Canada and 7% outside the country. Forty-five percent of the graduates work in government departments including community health agencies; 29% work in hospitals; 26% work in management consulting firms, software houses, or computer hardware firms. They work as systems/project analysts, systems consultants, research assistants, planning analysts, system-support staff, trainers/developers and client account representatives. Some are already in senior management positions.
Professional Qualification of German Physicians in Medical Informatics
Authors: Michaelis J. 
Published: March 2018

Abstract:In addition to the medical education in the Federal Republic of Germany which includes a compulsory Medical Informatics course there exists a formal program for professional qualification of physicians in Medical Informatics. After two years of clinical practice and 1.5 years of professional training at an authorized institution, a physician may receive in addition to the medical degree a “supplement Medical Informatics”. The qualification requirements are described in detail. Physicians with the additional Medical Informatics qualification perform responsible tasks in their medical domain and serve as partners for fully specialized Medical Informatics ex-’ perts in the solution of practical Medical Informatics problems. The formal qualification is available for more than 10 years, has become increasingly attractive, and is expected to grow with respect to future Medical Informatics developments.
Summary of the General Discussion
Authors: Douglas J. V. , Leiner F. 
Published: March 2018

Abstract:Five breakout groups at the 1992 International Working Conference on Health/Medical Informatics Education in Heidelberg/Heilbronn compared six programs, located in the United States, Canada, Great Britain, and Germany. Acknowledging the difficulties in comparing programs in different countries and at different degree levels, the groups proposed four different schemata for distinguishing among programs. Despite widely varying approaches, there was consensus on the need for a robust model for health/medical informatics curricula. The viewpoint of the presented summaries is necessarily that of the authors.
Comparison of Examinees’ and Doctors’ Judgement of Health Status Using Data in an AMHTS
Authors: Sekita Y. , Ohta T. , Inoue M. , Takeda H. 
Published: March 2018

SummaryJudgements of examinees’ health status by doctors and by the examinees themselves are compared applying multiple discriminant analysis. The doctors’ judgements of the examinees’ health status are studied comparatively using laboratory data and the examinees’ subjective symptom data.This data was obtained in an Automated Multiphasic Health Testing System. We discuss the health conditions which are significant for the judgement of doctors about the examinees. The results show that the explanatory power, when using subjective symptom data, is fair in the case of the doctors’ judgement. We found common variables, such as nervousness, lack of perseverance etc., which form the first canonical axis.
A Method for the Evaluation of Clinical Information, Exemplified for Bleeding Symptoms in Non-Severe von Willebrand’s Disease Type I
Authors: Wahlberg Th. B. 
Published: March 2018

SummaryStandardized questions with no- or yes-answers are often used for diagnostic purposes. One common approach is to register only positive answers or confirmation of symptoms, while negative findings are ignored. To illustrate the potential diagnostic value of positive and negative symptoms, twenty-two individuals with von Willebrand’s disease (vWd) type I and 50 non-vWd individuals from three families were investigated. From a self-administered questionnaire, mainly covering bleeding tendency, 19 symptoms were evaluated by a statistical method based on predictive values of negative and positive tests (indicators and predictors). Rank orders of negative findings indicating non-vWd and positive findings indicating vWd were calculated.
Bayesian Models for Clinical Studies
Authors: Schneider B. 
Published: March 2018

SummaryThe concept of Bayesian statistics, based on the model of random parameters with appropriate a priori distributions, is discussed and applied to the analysis of clinical studies (i. e. treatment comparisons). It is shown that assumptions about the a priori distribution can be eliminated if analysis is restricted to the class of conjugate prior distributions and the number of data is sufficiently high. For treatment comparisons the concept of “preferences” is introduced, i.e. the a posteriori probability for special rankings of the effect parameters. This concept is an alternative to hypothesis testing and error probabilities which is meaningless in Bayesian models. With this concept it is not necessary to formulate the hypotheses before the study or fix sample size or stopping rules in advance. It is also not necessary to restrict the analysis to the test of one or few hypotheses. On the other hand, the physician will not get error probabilities for his statements but “preferences” of the relevant rankings of the treatments.