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Biomedical subjects

R Klar

Publications and source records attributed to R Klar.

At least 19 recordsLinked to original sources
PubMed2006

[E-learning in the education and training of physicians. Methods, results, evaluation].

E-learning has been established in the education and training of physicians in various types: linear sequential and hyper-textual forms of multimedia presentations and texts, tutorial systems and simulations. Case-based e-learning systems are of special importance in medicine because they allow for mediation of process and practical knowledge by presentation of authentic medical cases in a simulated environment. The integration into the medical education and advanced professional training is crucial for the long-term success of e-learning; in case-based systems this can be accomplished by blended learning approaches which combine elements of traditional teaching with e-learning. Learning management systems (LMS) support integration of traditional teaching and e-learning by serving as an organizational platform for content of teaching. Further, they provide means of communication for trainers and trainees, authoring tools, interactive components, course management and role-based sharing concept. The dissemination of e-learning can be fostered by attention to requirements and user analysis, early adoption to organizational structures, curricular integration and continuous cooperation with students. Summarized, didactic and organizational aspects determine the success of our own e-learning offers as well as they influence the general further development of e-learning more than technical features.

Computer-Assisted Instruction↗
PubMed2004

Selected impressions on the beginning of the electronic medical record and patient information.

OBJECTIVES: To present an overview of early European and American work on Electronic Medical Records and patient information. METHOD: The invited lectures of "pioneers of electronic patient information" given at the farewell symposium of Wolfgang Giere in Frankfurt, Germany, are summarized and discussed. RESULTS: The origin of medical record writing goes back to Hippocrates and over many centuries this important medical duty was regarded as an annoying, laborious and error-prone task. First steps towards a better medical record started in 1936 with punch cards. In the 1960s the minimum basic data set, a unique patient ID was introduced and even for outpatients first computerized medical record systems were developed applying some important standards and well accepted data structures. Nowadays multimedia are included in patient record systems, highly specialized subsystems e.g. for radiology or cardiology are available, and semantic and statistic mining techniques as well as medical classifications and standardized terminologies support evaluation. All these methods should primarily improve the quality of care, reduce errors, improve communication between multiple specialists, reduce wait times for patients and improve efficiency. CONCLUSIONS: Over decades it became obvious that the structure of a medical record notably for coded data but also for narrative text and pictures must be carefully modelled. Well maintained standardized health terminologies and medical classifications are important issues for a user-friendly electronic medical record, which bring benefits for clinicians and patients.

Diffusion of Innovation↗
PubMed2003

[Electronic distribution of patient records and images through PACS: implementation of data protection at the University Hospital in Freiburg].

In large installations of a Picture Archiving and Communication System (PACS), data protection becomes an issue. Above all, not every employee should have access to all data stored in the system. At the Freiburg University Hospital, we developed a concept of dynamic assignment of authorization, assuring that every physician is authorized to the data of all patients under his care. We describe the technical implementation of data protection developed for the integration of PACS and electronic patient records in Freiburg. The system was installed in January 2001 and the experience of its two years in operation is reported.

Computer Security↗
PubMed2001

[Virtual conferences in medicine].

The Internet and high-speed communication facilities have tremendously simplified the exchange of multimedia data. E-mail and World Wide Web have become important tools for everyday information and communication. In recent years there have been numerous attempts to exploit web technology for virtual conferences. However, in the medical domain, only few virtual conferences could be established. We describe the architecture and typical features of virtual conferences, their organizational and technical requirements and discuss prerequisites for their successful implementation.

Computer Systems↗
PubMed2001

Health informatics world wide--a WWW service for the health informatics community.

Health Informatics World Wide, a Web index of research and educational institutions in the fields of Health Informatics and Medical Informatics has been available to WWW users since 1995. In this paper we report on the original conception of this service, its subsequent modifications and address its maintenance and related problems. Access statistics are presented which demonstrate its relevance as well as the geographical focus of Health Informatics research and development.

Abstracting and Indexing↗
PubMed2000

Automated coding of diagnoses--three methods compared.

In Germany, new legal requirements have raised the importance of the accurate encoding of admission and discharge diseases for in- and outpatients. In response to emerging needs for computer-supported tools we examined three methods for automated coding of German-language free-text diagnosis phrases. We compared a language-independent lexicon-free n-gram approach with one which uses a dictionary of medical morphemes and refines the query by a mapping to SNOMED codes. Both techniques produced a ranked output of possible diagnoses within a vector space framework for retrieval. The results did not reveal any significant difference: The correct diagnosis was found in approximately 40% for three-digit codes, and 30% for four-digit codes. The lexicon-based method was then modified by substituting the vector space ranking by a heuristic approach that capitalizes on the semantic structure of SNOMED, thus raising the number of correct diagnoses significantly (approximately 50% for three-digit codes, and 40% for four-digit codes). As a result, we claim that lexicon-based retrieval methods do not perform better than the lexicon-free ones, unless conceptual knowledge is added.

Abstracting and Indexing↗
PubMed2000

Semantic analysis of medical free texts.

The semantic interpretation of natural language utterances is usually based on a large number of transformation rules which map syntactic structures (parse trees) onto some kind of meaning representation. However, those interpretation rules exhibit an insufficient degree of abstraction so that the scalability and portability of such natural language processing systems is hard to maintain. In this paper, we introduce an approach that is able to cope with a wide variety of semantic interpretation patterns in medical free texts by applying a small inventory of abstract semantic interpretation schemata. These schemata address generalized graph configurations within syntactic dependency parse trees, which abstract away from specific syntactic constructions.

Computer Graphics↗
PubMed1999

Realization of a CPR using HL7 queries from communication server to information server.

A communication server is often used in Germany to interface legacy systems. It handles the translation, duplication, and transmission of messages to all systems that might need this information. Based on the principles of "for every data there is only one master" and "information on demand" we have built an information server that reduces the messages required and simplifies the handling of messages, the update of data already sent compared to a communication server. It also allows to implement a security policy as required by the German data privacy legislature.

Computer Communication Networks↗
PubMed1999

Towards a multilingual morpheme thesaurus for medical free-text retrieval.

We introduce a methodology for the segmentation of complex compounds into medically plausible morphemes. A tool for thesaurus compilation and management is presented, and design principles for a multilingual morpheme thesaurus are outlined. Our goal is to enhance the quality of medical free-text retrieval by replacing lexically based through morpheme-based search procedures.

Germany↗
PubMed1998

Quality criteria for electronic publications in medicine.

This paper defines "electronic publications in medicine (EPM)" as computer based training programs, databases, knowledge-based systems, multimedia applications and electronic books running on standard platforms and available by usual distribution channels. A detailed catalogue of quality criteria as a basis for development and evaluation of EPMs is presented. The necessity to raise the quality level of electronic publications is stressed considering aspects of domain knowledge, software engineering, media development, interface design and didactics.

Publishing↗
PubMed1998

Conversion problems concerning automated mapping from ICD-10 to ICD-9.

The increasing parallel use of ICD-9 and ICD-10 complicates the comparability of coded diagnoses. This is the reason why we developed a symmetric table for interactive conversion between ICD-9 and ICD-10, based on a vector space text-retrieval method that resulted in unambiguous mapping from ICD-9 to ICD-10 in 64%, from ICD-10 to ICD-9 in 87% of all three- and four-character classes of the tabular list. Out of the remaining 13% of multi-valued relations, a table for automated mapping from ICD-10 to ICD-9 was created. In 9% of cases, the selection offered no problems. A compromise between preserving information content and maintaining the logical integrity had to be found in 2.4%; in 1.6% automated mapping was impossible because of newly defined concepts and structural differences between ICD-9 and ICD-10 that are not counterbalanced by a consistent system of residual categories. We recommend that in a future revision of the ICD, compatibility with the then existing classification system should be considered.

Diagnosis, Computer-Assisted↗
PubMed1997

Computer-based training and electronic publishing in the health sector: tools and trends.

CBT (computer-based training) applications and hypermedia publications are two different approaches to the utilisation of computers in medical education. Medical CBT software continues to play a minor role in spite of the increasing availability, whereas hypermedia have become very popular through the World Wide Web (WWW). Based on the HTML format they can be designed by non-programmers using inexpensive tools while the production of CBT applications requires programming expertise. HTML documents can be easily developed to be distributed by a web-server or to run as local applications. In developed countries CBT and hypermedia have to compete with an abundance of printed or audio-visual media and a wealth of lectures, conferences, etc., whereas in developing countries these media are scarce and expensive. Here CBT programs, and hypermedia publications in particular, may be a cost-effective way to improve quality of education in the health sector.

Computer Communication Networks↗
PubMed1997

Critical success factors for a hospital-wide PACS.

Since 1996 a picture archiving and communications system (PACS) is installed at the university hospital of Freiburg. The PACS is integrated in the hospital information system (HIS) and several modalities of different vendors are attached to it. During the implementation phase three critical factors to the success of our PACS installation where identified: the support of the workflow, the interface of the radiological information system (RIS) to the modalities, and the security policy to allow hospital-wide access to the images and results in the PACS.

Computer Security↗
PubMed1995

The association of inflammatory bowel disease and leukemia--coincidence or not?

Inflammatory bowel diseases, (IBD) including Crohn's disease and ulcerative colitis, are chronic systemic disorders associated with intestinal and other systemic features. Common hematological manifestations of IBD include: anemia, hypercoagulable state, leukocytosis and thrombocytosis. Recently it has been recognized that lymphoma and leukemia can also be associated with both Crohn's disease and ulcerative colitis. Careful review of the literature reveals more than 30 cases of leukemia reported in patients with IBD. Epidemiological data show that this association is statistically significant (relative risk of 5.3; p < 0.01; 95% confidence interval). This review attempts to characterize the clinical features of this association. The etiology of leukemia in these cases seems to be multifactorial and may involve: genetic susceptibility, environmental factors, immune abnormalities, prior exposure to diagnostic radiation and a variety of therapeutic modalities. No definitive time interval, specific pattern or correlation between the extent of bowel involvement and type of leukemia was found. Treatment of leukemia might affect the activity and severity of the inflammatory bowel disease, but there is very little data relating to this issue. There is some evidence suggesting that bone marrow transplantation performed for leukemia may induce remission of both diseases. Further investigation is still required in the future in order to establish a definite relationship between these two disorders.

Adolescent↗
PubMed1995

The minimum basic data set as the core of the Freiburg University Hospital information system.

At the University Hospital Freiburg (1,927 beds; 53,000 inpatients/year), we developed and ran a Medical Information, Retrieval, and Archives System (MIRA) by integrating the Minimum Basic Data Set into the self developed patient administration system and all the other parts of our hospital information system. Especially for the physicians, MIRA offers access to basic medical data of all patients treated in all medical departments and separate buildings since 1986. MIRA is mainly used in cases of readmission and for scientific and managerial purposes. The privacy controlled access to the central patient data bases (records of 450,000 patients) of MIRA is possible via 610 online PCs and dialog terminals. Because of the many easy-to-use standard functions and special extensions for different clinical departments, MIRA became one of the best accepted edp systems for physicians, nurses and administrators.

Germany↗
PubMed1994

Managing expectations between patient and nurse.

With increasing consumer interest in the cost and quality of healthcare, it is imperative that patients' expectations of nursing care be recognized and managed. This concept is critical to the continued viability of any healthcare institution in the current competitive market. The authors describe the process that one hospital undertook in looking at patient satisfaction with nursing care, the modification of a patient satisfaction tool, and the development of a quality model of care.

Humans↗