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PubMed2001

Medical informatics and bioinformatics: European efforts to facilitate synergy.

Over the past decade there have been several attempts to rethink the basic strategies and scope of medical informatics. Meanwhile, bioinformatics has only recently experienced a similar debate about its scientific character. Both disciplines envision the development of novel diagnostic, therapeutic, and management tools, and products for patient care. A combination of the expertise of medical informatics in developing clinical applications and the focused principles that have guided bioinformatics could create a synergy between the two areas of application. Such interaction could have a great influence on future health research and the ultimate goal, namely continuity and individualization of health care. This article summarizes current activities related to facilitating synergy between medical informatics and bioinformatics, emphasizing activities in Europe while relating them to efforts in other parts of the world. The report provides examples of the analysis that European investigators are carrying out, aiming to propose new ideas for collaborations between medical informatics and bioinformatics researchers in a variety of areas.

Computational Biology↗
PubMed1997

The internal challenges of medical informatics.

Haux's [7] basic assumption that the object of medical informatics is: "... to assure and to improve the quality of healthcare as well as the quality of research and education in medicine and in the health sciences ..." is taken as a starting point to discuss the three main topics: What is the meaning of medical informatics (i.e. what should be the main activities of medical informatics to bring maximum benefit to medicine)? What are the achievements and failures of medical informatics today (again considering the impact on the quality of healthcare)? What are the main challenges? Concerning the definition of medical informatics it is argued that one should not hide the link to basic informatics and, for that matter to computers, completely behind abstract definitions. After an analysis of the purposes of the definition of a discipline, a differentiated definition of the scope of medical informatics, rather general when concerning the field of scientific interest, more focused when concerning the practical (constructive) applications, is proposed. Contrasting Haux's chapter on achievements of medical informatics we concentrate on and analyse non fulfilled promises of medical informatics to derive lessons for the future and to propose 'generic' (or core) tasks of medical informatics to meet the challenges of the future. A set of 'internal challenges' of medical informatics to change priorities and attitudes within the discipline is put forward to enable medical informatics to meet the 'external challenges' listed by Haux.

Artificial Intelligence↗
PubMed2006

Fifty years in medical informatics.

OBJECTIVES: An overview of personal experiences in medical informatics based on Dr. Morris Collen's 50 years of research in the field. METHODS: A personal reminiscence and historical overview, focusing on the first two decades of medical informatics, when Dr. Collen began working with Dr. Sidney Garfield, the founder of Kaiser Permanente, leading to his involvement in computer-based medical care, through the development of the pioneering Automated Multiphasic Health Testing (AMHT) system, which they introduced into Kaiser clinics in Oakland and San Francisco. RESULTS: Statistical models for medical decision-making based on consultations with Jerzy Neyman and George Dantzig were incorporated into the AMHT, and tested on a large database of cases. Meetings with other pioneers in medical informatics at the Karolinska Institute led to the formation of the early society Salutas Unitas, and the many national and international collaborations which followed during the first two decades helped coalesce the field as clinicians and researchers investigated problems of medical data, decision support, and laboratory, hospital, and library information systems. CONCLUSION: Dr. Collen's research and his many medical informatics activities significantly contributed to the growth of the field. The U.S. contributions are covered extensively in his book, A History of Medical Informatics in the United States, 1950-1990. Washington, DC: Am Med Informatics Association 1995.

Diagnosis, Computer-Assisted↗
PubMed2004

MRI-based individual 3D region-of-interest atlases of the human brain: a new method for analyzing functional data.

OBJECTIVES: Introduction of a new atlas-based method for analyzing functional data which takes into account the variability of individual human brains and the partial volume, effects of functional emission computed tomography, images in complex anatomical 3D regions, as well as, describing the underlying multi-modal image processing, principles. METHODS: 3D atlas extraction is done directly by automated segmentation of individual magnetic resonance images of the patient's head. This is done in two steps: voxel-based classification of T1-weighted images for tissue differentiation (low-level processing) is followed by knowledge-based analysis of the classified images for extraction of 3D anatomical regions (high-level processing). For atlas-based quantification of co-registered functional images, 3D anatomical regions can be convoluted with an idealized point spread function of the emission computed tomography system, after which a partial volume-dependent threshold can be determined. RESULTS: Quantitative evaluation studies, based on 50 realistic software head phantoms and 24 image data sets obtained from healthy subjects and patients, show low misclassification rates and stable results for the neural network-based classification approach (mean +/- SD 3.587 +/- 0.466%, range 2.726-4.927%) as well as for the adjustable parameters of the knowledge-based approach. Computation time is <5 min for classification, <1 min for most of the extraction algorithms. The influence of the partial volume-dependent threshold is shown for an activation study. CONCLUSIONS: This new method allows 3D atlas generation without the need to warp individual image data to an anatomical or statistical brain atlas. Going beyond the purely tissue-oriented approach, partial volume effects of emission computed tomography images can be analyzed in complex anatomical 3D regions.

Algorithms↗
PubMed1986

Medical expert systems--knowledge tools for physicians.

Recent advances in the field of artificial intelligence have led to the emergence of expert systems, computational tools designed to capture and make available the knowledge of experts in a field. Although much of the underlying technology available today is derived from basic research on biomedical advice systems during the 1970s, medical application packages are thus far generally unavailable from the young artificial intelligence industry. Medical expert systems will begin to appear, however, as researchers in medical artificial intelligence continue to make progress in key areas such as knowledge acquisition, model-based reasoning and system integration for clinical environments. It is accordingly important for physicians to understand the current state of such research and the theoretic and logistic barriers that remain before useful systems can be made available. One experimental system, ONCOCIN, provides a glimpse of the kinds of knowledge-based tools that will someday be available to physicians.

Drug Therapy, Computer-Assisted↗
PubMed1998

Intelligent agent for collaborative diagnosis.

An agent-based approach to facilitating cooperative medical diagnosis is presented in this paper. Background work in computer supported cooperative work and medical informatics is first discussed. Relevant theory for interaction management is then considered. An agent-based interaction is then shown via a case study to facilitate cooperative diagnosis. This is achieved through monitoring patient record construction and by highlighting relevant diagnostic information.

Computer Communication Networks↗
PubMedDate not supplied

The important role of international exchange in the development of medical informatics in developing countries: a report from China.

China is a developing country, and so is inferior to the developed countries in many aspects of science and technology. It is similarly a new member in the world ranking of the application of computers in biomedicine. However, since implementing the policy of reform and opening to the outside world in 1976, China has achieved greater success in biomedical signal and image processing, biomedical data processing, computer-aided diagnosis, computerized hospital management, etc. China's development shows that international exchange and cooperation are very important for the development of medical informatics in developing countries, and the application of computers in biomedicine has progressively spread all over the world and is increasingly taking root in the hearts of the people.

China↗
PubMedDate not supplied

AIDA for reproductive medicine and the fertility clinic.

A Medical Information System for the Fertility Department has been built (VERGYNIA) using the 4th generation software package AIDA to make the medical data accessible for research and teaching on the one hand and to assist the management of the department in the daily routine of patient care on the other. The system has been implemented on a PDP 11/23 computer with a 20 Mbyte hard disk, a 10 Mbyte removable disk and 128 Kbyte central memory. Three visual display terminals and a small printer are connected to the system. A dedicated line connection between this system and the computer facilities of the Department of Medical Informatics allows easy transfer of data for analysis by statistical packages and the transfer of new programs to the computer of the Fertility Department. The PDP 11/23 contains a production system, a developmental system, and a separate environment for research which can all three run simultaneously on the same computer without interfering with each other. VERGYNIA was predominantly constructed with AIDA; only parts of the output programs have been programmed in MUMPS, due to the fact that the required AIDA tools were not yet available at the time of development. The original version of VERGYNIA was already in operation in 1982 and was built with the tools that form the basis of the current AIDA release. Due to many ad hoc modifications and additions, the system needed a total redesign in order to make it compatible with the new enhancements of the current AIDA release. This redesign was carried out during 1985.

Ambulatory Care Information Systems↗
PubMed2002

Visualization methods for data analysis and planning in medical applications.

Time plays an important role in medicine, both the past and the future. The medical history of a patient represents the past, which needs to be understood by the physician to make the right decisions. The past contains two different kinds of information: measured data (such as blood pressure) and incidents (such as seizures). Planning therapies, on the other hand, requires looking into the future to a certain extent. Visual representations exist for both the past and the future, and they are very useful for getting a better understanding of data or a plan. This paper surveys visualization techniques for both data analysis and planning, and compares them based on a number of criteria.

Computer Graphics↗
PubMed2004

Computer science education for medical informaticians.

The core curriculum in the education of medical informaticians remains a topic of concern and discussion. This paper reports on a survey of medical informaticians with Master's level credentials that asked about computer science (CS) topics or skills that they need in their employment. All subjects were graduates or "near-graduates" of a single medical informatics Master's program that they entered with widely varying educational backgrounds. The survey instrument was validated for face and content validity prior to use. All survey items were rated as having some degree of importance in the work of these professionals, with retrieval and analysis of data from databases, database design and web technologies deemed most important. Least important were networking skills and object-oriented design and concepts. These results are consistent with other work done in the field and suggest that strong emphasis on technical skills, particularly databases, data analysis, web technologies, computer programming and general computer science are part of the core curriculum for medical informatics.

Curriculum↗
PubMed2002

Evaluation of medical informatics curriculum at the Rijeka University School of Medicine in Croatia.

This paper presents preliminary results from the study to evaluate the Medical Informatics curriculum at the Rijeka University School of Medicine, Rijeka, Croatia. Evaluation is based on the written anonymous. survey filled out by students after passing the exam. Questionnaire consisted of questions considering basic data (age, gender, study year, etc.), as well as students' opinions and marks on informatics, computer usage and teaching skills during the lessons. In total 459 students from five consecutive generations (from 1996/97 to 2000/01) were evaluated. Collected data define guidelines for teachers to improve organization and contents of curriculum. This study proved that, from one generation to the next, students show more and more interest in Medical Informatics, more of them have their own computer and more of them use Internet and e-mail communication.

Croatia↗
PubMed2003

Medical informatics--a catalyst for operating room transformation.

For many years, computers have supported complex clinical ancillary functions such as the laboratory, radiology, endoscopy, and others. Digital computers have been successfully incorporated into specialized clinical instruments to offer advanced digital devices such as fetal monitors, heart monitors, and imaging equipment. But these devices are often not fully integrated with clinical management and operational systems. Beyond ancillary department applications, the result of almost 30 years of trying to automate the clinical processes in healthcare is large investments in both computer systems and paper medical records that have resulted in paper-based, computer-assisted processes of care. This expensive combination of partial clinical automation and archaic paper-based support processes is a major obstacle to improvements in care delivery and management. The need to use software, informatics, and standards to help manage the operating room and perioperative processes of care is significant. The potential to reduce adverse events, cost of care, and to enhance the quality of care are real and worth attaining. This paper focuses on what medical informatics improvements are needed to support improvements in surgical care and to assist in the management of the highly complex operating room and perioperative care process, and proposes research priorities in these areas.

Humans↗