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Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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PubMed2002

Interactive telemedical applications in OP 2000 via satellite.

Using off-the-shelf hardware components and a specially developed high-end software communication system (WinVicos) satellite networks for interactive telemedicine have been designed and developed. These networks allow for various telemedical applications, like teleteaching, telementoring, intraoperative teleconsultation, second opinioning, etc.. Based on the successful GALENOS network, several projects are currently being realized: MEDASHIP (Medical Assistance for Ships); DELTASS (Disaster Emergency Logistic Telemedicine Advanced Satellites Systems) and EMISPHER (Euro-Mediterranean Internet-Satellite Platform for Health, medical Education and Research).

Computer Communication Networks↗

PubMed1995

Informatics for care protocols and guidelines: towards a European knowledge model.

The DILEMMA Generic Protocol Model (DGPM) is a trans-national ontology of clinical protocols designed using a blend of logic engineering and business modelling techniques, and developed as part of the AIM programme's DILEMMA project. It allows the declarative representation of clinical activities and the knowledge associated with them. It is being used to represent protocols of all sorts-including standards and guidelines-for use in acute, primary, home and shared care. Central to the model are the states that protocol-derived actions can assume, and the statements that must be true before transitions between those states can be proposed. Proposed transitions may then be scrutinised by clinicians, patients and carers, and approved or rejected. This approach enables the model to handle anticipated exception situations, as well as more normal protocol selection and application. Links to multi-media material are being investigated, to enable users to examine the evidence upon which protocols are based, and to provide decision support where deterministic reasoning is not readily available. The model is being discussed with other AIM projects, with a view to developing a European consensus, and generating a version of the model for submission to CEN TC251 as a European pre-normative standard.

Artificial Intelligence↗

PubMed2006

Bridging clinical information systems and grid middleware: a Medical Data Manager.

This paper describes the effort to deploy a Medical Data Management service on top of the EGEE grid infrastructure. The most widely accepted medical image standard, DICOM, was developed for fulfilling clinical practice. It is implemented in most medical image acquisition and analysis devices. The EGEE middleware is using the SRM standard for handling grid files. Our prototype is exposing an SRM compliant interface to the grid middleware, transforming on the fly SRM requests into DICOM transactions. The prototype ensures user identification, strict file access control and data protection through the use of relevant grid services. This Medical Data Manager is easing the access to medical databases needed for many medical data analysis applications deployed today. It offers a high level data management service, compatible with clinical practices, which encourages the migration of medical applications towards grid infrastructures. A limited scale testbed has been deployed as a proof of concept of this new service. The service is expected to be put into production with the next EGEE middleware generation.

Databases as Topic↗

PubMed1995

Assessment of the level of the actual and desirable levels of computer literacy, usage and expected knowledge of undergraduate students of nursing.

The aim of the study was to determine the perceptions of students entering nursing at the bachelors level, of their actual and desirable knowledge about computers and their applications relevant to nursing and health care. Within the health care system the use of computerized systems is increasing rapidly. In Australia, the NSW Health Department's Information Management Resource Consortium pilot project--to introduce the First Data Hospital Information System into NSW public hospitals--is a significant example of this trend. While the importance of computerized systems is fairly well recognized for the areas of management and research, they are becoming increasingly significant in the delivery of clinical care and quality assurance. It is important that nurses during their undergraduate education develop the computer literacy and awareness that will allow them access to the both the information and its management. To achieve this effectively it is essential to determine both the entry knowledge of students and what skills and knowledge are essential and desirable for their future roles as nurses. The research undertaken replicated an American study [2] and used their validated questionnaire. Both pre-registration(n=20) and post-registration (n=24) undergraduate students responded to a 21 item questionnaire. The issues addressed related to computer literacy, usage, and knowledge of clinical applications. Both groups desired more "hands on" experience and knowledge in the nurse's role in developing applications and using computers to help care for patients. These results were consistent with the Parks et. al. study. The significance of comparing actual and desirable levels of computer knowledge and awareness is in assisting educators to shape curriculum and course content to more effectively meet the educational needs of these groups in terms of Health Informatics.

Attitude to Computers↗

PubMed1996

Future directions for the Agency for Health Care Policy and Research.

The Agency for Health Care Policy and Research (AHCPR) plays a leading role in health services research. Research efforts to develop practice guidelines, outcomes research, and computer applications have led to improvements in the delivery of care and reduced health care costs. These efforts aid consumers, providers, purchasers, and policy makers in health care decision making. This article cites numerous examples of AHCPR's efforts to increase quality of care and reduce costs.

Community Participation↗

PubMed1998

A component-based problem list subsystem for the HOLON testbed. Health Object Library Online.

One of the deliverables of the HOLON (Health Object Library Online) project is the specification of a reference architecture for clinical information systems that facilitates the development of a variety of discrete, reusable software components. One of the challenges facing the HOLON consortium is determining what kinds of components can be made available in a library for developers of clinical information systems. To further explore the use of component architectures in the development of reusable clinical subsystems, we have incorporated ongoing work in the development of enterprise terminology services into a Problem List subsystem for the HOLON testbed. We have successfully implemented a set of components using CORBA (Common Object Request Broker Architecture) and Java distributed object technologies that provide a functional problem list application and UMLS-based "Problem Picker." Through this development, we have overcome a variety of obstacles characteristic of rapidly emerging technologies, and have identified architectural issues necessary to scale these components for use and reuse within an enterprise clinical information system.

Computer Systems↗

PubMed2003

New terminology services based on term comparison using semantic definitions and similarity computation.

As medical information can be encoded within different terminological systems, terms comparison is an important issue to allow communication between applications. In description logics, terms are compared by the means of semantic definitions and subsumption relations. Similarity is also a convenient method for term comparison but is not supported by terminology servers which implement subsumption relations. We present new terminology services built on a semantic distance that could help for semantic mediation between medical applications ranging from semi-automatic encoders to data mining tools. These services are 1) comparison between terms 2) k-nearest-neighbors 3) support for concept coding 4) automatic generation of similarity tables 5) distance based queries 6) support for clustering.

Artificial Intelligence↗

PubMed2006

New trends in the virtualization of hospitals--tools for global e-Health.

The development of virtual hospitals and digital medicine helps to bridge the digital divide between different regions of the world and enables equal access to high-level medical care. Pre-operative planning, intra-operative navigation and minimally-invasive surgery require a digital and virtual environment supporting the perception of the physician. As data and computing resources in a virtual hospital are distributed over many sites the concept of the Grid should be integrated with other communication networks and platforms. A promising approach is the implementation of service-oriented architectures for an invisible grid, hiding complexity for both application developers and end-users. Examples of promising medical applications of Grid technology are the real-time 3D-visualization and manipulation of patient data for individualized treatment planning and the creation of distributed intelligent databases of medical images.

Artificial Intelligence↗

PubMed2005

Modeling and designing a proteomics application on PROTEUS.

OBJECTIVES: Biomedical applications, such as analysis and management of mass spectrometry proteomics experiments, involve heterogeneous platforms and knowledge, massive data sets, and complex algorithms. Main requirements of such applications are semantic modeling of the experiments and data analysis, as well as high performance computational platforms. In this paper we propose a software platform allowing to model and execute biomedical applications on the Grid. METHODS: Computational Grids offer the required computational power, whereas ontologies and workflow help to face the heterogeneity of biomedical applications. In this paper we propose the use of domain ontologies and workflow techniques for modeling biomedical applications, whereas Grid middleware is responsible for high performance execution. As a case study, the modeling of a proteomics experiment is discussed. RESULTS: The main result is the design and first use of PROTEUS, a Grid-based problem-solving environment for biomedical and bioinformatics applications. CONCLUSION: To manage the complexity of biomedical experiments, ontologies help to model applications and to identify appropriate data and algorithms, workflow techniques allow to combine the elements of such applications in a systematic way. Finally, translation of workflow into execution plans allows the exploitation of the computational power of Grids. Along this direction, in this paper we present PROTEUS discussing a real case study in the proteomics domain.

Algorithms↗

PubMed2001

Informatics application provides instant research to practice benefits.

A web-based research information system was designed to enable our research team to efficiently measure health related quality of life among frail older adults in a variety of health care settings (home care, nursing homes, assisted living, PACE). The structure, process, and outcome data is collected using laptop computers and downloaded to a SQL database. Unique features of this project are the ability to transfer research to practice by instantly sharing individual and aggregate results with the clinicians caring for these elders and directly impacting the quality of their care. Clinicians can also dial in to the database to access standard queries or receive customized reports about the patients in their facilities. This paper will describe the development and implementation of the information system. The conference presentation will include a demonstration and examples of research to practice benefits.

Abstracting and Indexing↗

PubMed2004

The road ahead.

The recent events dedicated to eHealth, such as eHealth 2003 and eHealth 2004 Ministerial conferences and exhibition, demonstrated clearly that a critical mass of users is being created who already use eHealth services and applications. Citizens, patients and health professionals are experiencing growing benefits from the use of eHealth applications which can increase citizen information, increase patient empowerment, speed up delivery, and reduce medical risks. Yet despite their availability and proven benefits, eHealth systems and services are not yet widely used in real-life medical or health situations. In many places, development is still at a pilot phase, often financed through research grants.

Congresses as Topic↗

PubMed2003

eHealth for Europe.

eHealth has been defined as "a means of applying new low cost electronic technologies, such as 'web enabled' transactions, advanced networks and new design approaches, to healthcare delivery. In practice, it implies not only the application of new technologies, but also a fundamental re-thinking of healthcare processes based on using electronic communication and computer-based support at all levels and for all functions both within the healthcare service itself and in its dealings with outside suppliers. eHealth is a term which implies a way of working rather than a specific technology of application". As the chairman of the eHealth Working Group of the European Health Telematics Association and as an Honorary Consultant Physician at the Great Ormond Street Hospital for Children as well as a Consultant Paediatrician at the Portland Hospital for Women and Children, the author tries to identify relevant aspects of eHealth for Europe.

Europe↗

PubMed2004

A linear programming approach to limited angle 3D reconstruction from DSA projections.

OBJECTIVES: We investigate the feasibility of binary-valued 3D tomographic reconstruction using only a small number of projections acquired over a limited range of angles. METHODS: Regularization of this strongly ill-posed problem is achieved by (i) confining the reconstruction to binary vessel/non-vessel decisions, and (ii) by minimizing a global functional involving a smoothness prior. RESULTS: Our approach successfully reconstructs volumetric vessel structures from three projections taken within 90 degrees. The percentage of reconstructed voxels differing from ground truth is below 1%. CONCLUSION: We demonstrate that for particular applications--like Digital Subtraction Angiography--3D reconstructions are possible where conventional methods must fail, due to a severely limited imaging geometry. This could play an important role for dose reduction and 3D reconstruction using non-conventional technical setups.

Angiography, Digital Subtraction↗

PubMed1995

Framework for quality assessment of knowledge.

One of the key issues in the development (and subsequent application) of medical knowledge-be it in terms of a KBS or otherwise-is the assessment of its quality. We present a framework for how to manage and make measurable the quality of the semantic as well as pragmatic aspects of the knowledge embedded in classification models during the development of such models.

Artificial Intelligence↗

PubMed1999

Inventory of validation approaches in selected health telematics projects.

This paper presents the results from an inventory of validation approaches and methodologies which have been used in selected health telematics projects. The inventory was performed in the VATAM Validation of Telematic Applications in Medicine project, HC1115HC. The purpose of the inventory was to analyse the methodologies and their application assumptions in order to identify possibilities for harmonization and consolidation. The inventory was performed using five validation dimensions: IT-development; quality; user; technology assessment and marketing. The inventory results show that possibilities exist to synthesise methodologies and to provide practical guidance and support for projects that are developing health telematics applications. All stakeholders in health telematics projects, i.e. users, health care decision-makers, developers, suppliers and IT-industries, can benefit from practical validation guidelines and support for validation when guidelines are represented in a usable, easy to access and informative way.

Humans↗

PubMed2004

Automated hybrid TACT volume reconstructions.

OBJECTIVES: To design, implement in Java, and evaluate a method and means for the automated localization of artificial landmarks in optical images for tuned-aperture computed tomography (TACT) that allows the replacement of radiographic with optical landmarks. METHODS: Circular, colored, optical landmarks were designed to provide flexibility with regard to landmark constellation, imaging equipment, and lighting conditions. The landmark detection was based on Hough transforms (HT) for ellipses and lines. The HT for ellipses was extended to enable selective detection of bright ellipses on a dark background and vice versa, and the number of irrelevant votes in the accumulator arrays was reduced. An experiment was performed in vitro to test the automated landmark localization scheme, verify registration accuracy, and measure the required computation time. RESULTS: A visual evaluation of the tomographic slices that were produced using the new method revealed good registration accuracy. A comparison to tomographic slices similarly produced by means of conventional TACT showed identical results. The algorithm ran sufficiently fast on standard hardware to allow landmark localization in "real time" during successive image acquisition in clinical applications. CONCLUSIONS: The proposed method provides robust automated localization of landmarks in optical images. Using a hybrid imaging system, TACT can now be clinically applied without manual interaction of a human operator and without radiopaque landmarks, which might cover anatomic details of diagnostic interest.

Algorithms↗

PubMed1998

Communication technologies and applications in a medical environment.

As we move into the next millennium, we anticipate a rapid introduction of Information and Communication Technologies (ICTs) into the medical environment. In applying these technologies in Health Care Environments, the basic goals are to improve: (a) the collaboration between the different partners in the health sector, (b) the access to care and (c) the medical education, and to enhance overall quality (by increasing the availability of some applications, improve the quality of others and facilitate some completely new ones), and all these at affordable cost. This requires close interaction between health care practitioners and information technologists to ensure that the proposed technologies satisfy current user's needs, and anticipate future. The public awareness and the acceptance of the new medical environments by the users are key factors for successful implementations.

Computer Communication Networks↗

PubMed2005

The Grid as a healthcare provision tool.

OBJECTIVES: This paper presents a survey on HealthGrid technologies, describing the current status of Grid and eHealth and analyzing them in the medium-term future. The objective is to analyze the key points, barriers and driving forces for the take-up of HealthGrids. METHODS: The article considers the procedures from other Grid disciplines such as high energy physics or biomolecular engineering and discusses the differences with respect to healthcare. It analyzes the status of the basic technology, the needs of the eHealth environment and the successes of current projects in health and other relevant disciplines. RESULTS: Information and communication technology (ICT) in healthcare is a promising area for the use of the Grid. There are many driving forces that are fostering the application of the secure, pervasive, ubiquitous and transparent access to information and computing resources that Grid technologies can provide. However, there are many barriers that must be solved. Many technical problems that arise in eHealth (standardization of data, federation of databases, content-based knowledge extraction, and management of personal data ...) can be solved with Grid technologies. CONCLUSIONS: The article presents the development of successful and demonstrative applications as the key for the take-up of HealthGrids, where short-term future medical applications will surely be biocomputing-oriented, and the future of Grid technologies on medical imaging seems promising. Finally, exploitation of HealthGrid is analyzed considering the curve of the adoption of ICT solutions and the definition of business models, which are far more complex than in other e-business technologies such ASP.

Data Collection↗