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PubMed1987

Medical applications of computers: an overview.

In this review computer applications in medicine are discussed from the point of view of the levels of information processing as suggested by van Bemmel. Applications are presented and research directions indicated. The purpose of this review article is to give an overview of the field of medical informatics. A structural approach is followed in discussing the subjects of communication, databases, complex calculations (including signal analysis and image analysis techniques), pattern recognition and expert systems. The role the computer system plays in relation to the physician is discussed. It is stressed that computers cannot replace the physician, because computer systems use programs, that are of a scientific nature. This means that only certain aspects are taken into account and that one abstracts from individuality. Therefore, computers are unable to give advice about individual patients regarding their future.

Database Management Systems↗
PubMed1992

Recommendations of the German Association for Medical Informatics, Biometry and Epidemiology for education and training in medical informatics.

In the fields of health care and medicine there is an immense demand for a systematic application of methods of information processing and for the use of computers. Obviously, to that end well-trained scientists and qualified personnel must be available. With the present recommendations on education and training in medical informatics the German Association for Medical Informatics, Biometry and Epidemiology (GMDS) proposes structure and contents of medical informatics curricula and courses. The recommendations describe a 2-dimensional educational framework with different education levels in one dimension and various types of educational needs and orientation in the other one. The recommendations comprise at the university level education as well specialized curricula covering the total spectrum of medical informatics as well as informatics curricula with medical informatics as integrated applied subject or subsidiary subject, respectively. Besides these informatics-oriented approaches medical-oriented programs of education in medical informatics are recommended, e.g., post-graduate education in medical informatics for physicians based on foundations in medical informatics as part of their initial training in medicine. At the level of polytechnical schools curricula of medical documentation and informatics and at the level of professional schools training in medical documentation are recommended. This report is a translation of its German original. Although considered by the GMDS as recommendations for the Federal Republic of Germany, the text may also contribute to the development of an international, especially European framework of training in medical informatics.

Germany↗
PubMed2004

Medical privacy protection based on granular computing.

Based on granular computing methodology, we propose two criteria to quantitatively measure privacy invasion. The total cost criterion measures the effort needed for a data recipient to find private information. The average benefit criterion measures the benefit a data recipient obtains when he received the released data. These two criteria remedy the inadequacy of the deterministic privacy formulation proposed in Proceedings of Asia Pacific Medical Informatics Conference, 2000; Int J Med Inform 2003;71:17-23. Granular computing methodology provides a unified framework for these quantitative measurements and previous bin size and logical approaches. These two new criteria are implemented in a prototype system Cellsecu 2.0. Preliminary system performance evaluation is conducted and reviewed.

Computing Methodologies↗
PubMed2005

Knowledge for medicine and health care--laudation at the occasion of the honorary doctorate bestowed to Donald A. B. Lindberg by UMIT, University for Health Sciences, Medical Informatics and Technology in Innsbruck, Tyrol, Austria.

Dr. Donald A. B. Lindberg, Director of the U.S. National Library of Medicine, received an honorary doctorate from UMIT, the University for Health Sciences, Medical Informatics and Technology in Innsbruck, Tyrol. The celebration took place on September 28, 2004 at an academic event during a conference of the Austrian, German, and Swiss Societies of Medical Informatics, GMDS2004. Dr. Lindberg has been a pioneer in the field of computers in health care from the early 1960s onwards. In 1984 he became the Director of the National Library of Medicine in Bethesda, the world's largest fully computerized biomedical library. Dr. Lindberg has been involved in the early activities of the International Medical Informatics Association (IMIA), among others being the chair of the Organizing Committee for MEDINFO 86 in Washington D.C. He was elected the first president of the American Medical Informatics Association (AMIA), and served as an editor of Methods of Information in Medicine.

Austria↗
PubMed2001

Advances in biomedical engineering.

The most visible contributions of biomedical engineering to clinical practice involve instrumentation for diagnosis, therapy, and rehabilitation. Cell and tissue engineering also have emerged as clinical realities. In the next 25 years, advances in electronics, optics, materials, and miniaturization will accelerate development of more sophisticated devices for diagnosis and therapy, such as imaging and virtual surgery. The emerging new field of bioengineering-engineering based in the science of molecular cell biology-will greatly expand the scope of biomedical engineering to tackle challenges in molecular and genomic medicine.

Biocompatible Materials↗
PubMed1994

Rationale for the Arden Syntax.

The Arden Syntax, a language designed for writing and sharing task-specific knowledge for Medical Logic Modules (MLMs), has been recently accepted as a standard by the ASTM. The syntax is concerned with the critical task of sharing medical knowledge bases across many institutions. Because of the relative lack of agreement on vocabularies and data standards and because of the many other obstacles, the developers of the Arden Syntax took a pragmatic, straightforward approach that has borne fruit in a very short period of time. The syntax provides a vehicle for the health care community to begin sharing, so that we can see what works and what does not work, and we can begin to address the critical obstacles. In designing a language like the Arden Syntax, the authors make many decisions--but the final document gives only the result of these decisions without any explanation. By writing down the rationale behind the design of the syntax, we hope to aid users of the language, implementors of the language, and future designers of new languages.

Artificial Intelligence↗
PubMed1989

Expert systems in laboratory medicine: a practical consultative application.

Today, more than ever, clinical pathologists will be required to act as consultants, while at the same time coping with ever-increasing workloads. We present a knowledge-based expert system for providing interpretive reports on over 100 specimens per day in a large commercial laboratory. The program's developmental history is reviewed, followed by a description of the program's structure and operation and how it is used and edited.

Diagnosis, Computer-Assisted↗
PubMed2007

An integrated approach to a teaching file linked to PACS.

To meet the educational needs of a medical imaging department with a strong teaching commitment, a teaching file that uses digital data supplied by the institutional picture archiving and communications system (PACS) was required. This teaching file had to be easily used by the end users, have a simple submission process, be able to support multiple users, be searchable on all data fields, and implementing the teaching file must not incur any additional software or hardware costs. The teaching file developed to address this problem takes advantage of the database structure and capabilities of several components included in the commercial PACS installed at the hospital. MS Access is used to seamlessly integrate with the digital imaging and communication in medicine (DICOM) database of a normal work station that is part of the PACS. This integration allows relevant patient and study demographics to be copied from images of interest and then to be stored in a separate database as the back-end of the digital teaching file. When images for a particular teaching file case need to be reviewed, they are automatically retrieved and displayed from the main PACS database using an open application programming interface (API) connection defined on the PACS web server. Utilizing this open API connection means the teaching file contains only the relevant demographic information of each teaching file case; no image data is stored locally. The open API connection allows access to imaging data usually not encountered in a teaching file, allowing more comprehensive imaging case files to be developed by the radiologist. Other advantages of this teaching file design are that it does not duplicate image data, it is small allowing simple ongoing backup, and it can be opened with multiple users accessing the database without compromising data access or integrity.

Computer-Assisted Instruction↗
PubMedDate not supplied

AIDA for the automation of the patient history.

This article describes the application of a fourth-generation programming package (AIDA) for the construction of an interactive system for history-taking. It is shown that this system has been made very flexible and user-friendly, and that patients can easily answer all questions themselves. Parts of the system, that are supported by AIDA, are an interactive terminal with special, illuminated function keys, a screen driver for the generation and maintenance of 28 different screens, extensive help texts (with 260 help messages), and a report generator. The screens contain altogether 402 questions, through which 434 different answers can be given on 179 different items. The system has been evaluated extensively.

Computer Systems↗
PubMed2004

Data mining techniques for cancer detection using serum proteomic profiling.

OBJECTIVE: Pathological changes in an organ or tissue may be reflected in proteomic patterns in serum. It is possible that unique serum proteomic patterns could be used to discriminate cancer samples from non-cancer ones. Due to the complexity of proteomic profiling, a higher order analysis such as data mining is needed to uncover the differences in complex proteomic patterns. The objectives of this paper are (1) to briefly review the application of data mining techniques in proteomics for cancer detection/diagnosis; (2) to explore a novel analytic method with different feature selection methods; (3) to compare the results obtained on different datasets and that reported by Petricoin et al. in terms of detection performance and selected proteomic patterns. METHODS AND MATERIAL: Three serum SELDI MS data sets were used in this research to identify serum proteomic patterns that distinguish the serum of ovarian cancer cases from non-cancer controls. A support vector machine-based method is applied in this study, in which statistical testing and genetic algorithm-based methods are used for feature selection respectively. Leave-one-out cross validation with receiver operating characteristic (ROC) curve is used for evaluation and comparison of cancer detection performance. RESULTS AND CONCLUSIONS: The results showed that (1) data mining techniques can be successfully applied to ovarian cancer detection with a reasonably high performance; (2) the classification using features selected by the genetic algorithm consistently outperformed those selected by statistical testing in terms of accuracy and robustness; (3) the discriminatory features (proteomic patterns) can be very different from one selection method to another. In other words, the pattern selection and its classification efficiency are highly classifier dependent. Therefore, when using data mining techniques, the discrimination of cancer from normal does not depend solely upon the identity and origination of cancer-related proteins.

Biomarkers, Tumor↗
PubMed2006

Can design principles of traditional learning theories be fulfilled by computer-based training systems in medicine: the example of CAMPUS.

PURPOSE: Computer-based training (CBT) systems offer the potential to efficiently support modern teaching and learning. However, it is still unknown if a similar efficient learning experience built on sound learning theories and corresponding design principles can be created in the complex health care environment. The purpose of this paper is to analyse to what extent learning theories and corresponding design principles are relevant and can successfully be applied in computer-based training in medicine. METHODS: We use the case-based CBT system CAMPUS as an example for a CBT system currently used to enhance the medical teaching and learning experience. We apply two well-accepted learning theories (Bloom's taxonomy and practice fields) and related design principles to determine to what extent they are relevant and fulfilled in the context of CAMPUS. RESULTS: We demonstrate that in principle these learning theories and design principles can be implemented using computer-based training. However, not all design principles can be fulfilled by the system alone; rather the integration of the system into adequate -- traditional or virtual -- teaching and learning environments is essential. CONCLUSIONS: Traditional learning theories and design principles are a valuable means in designing adequate CBT systems in medicine. They can be successfully implemented in CBT systems for medical education if the system itself is adequately integrated into teaching and learning environments.

Computer-Assisted Instruction↗
PubMed2006

Comparing approaches for advanced e-health security infrastructures.

OBJECTIVES: The healthcare systems of all developed countries face the challenge for improving quality, efficiency and safety of patients' care. For meeting this challenge, health is moving from being organisation-centred to process-based care. This process will continue in the future turning health towards person-centred architectures. This system transformation is combined with extended and advanced communication and collaboration supported and enabled by appropriate information and communication technologies (ICT), also called e-health. The resulting solutions have to be trustworthy. METHODS: There is a set of security services needed for realising trustworthy e-health solutions. Those security services must be comprehensively integrated in the e-health application. Furthermore, a set of infrastructure services has to be specified and implemented. For keeping the solutions future-proof, they have to comply with architectural principles and paradigms. RESULTS: After shortly introducing meanwhile internationally acknowledged architectural paradigms for applications, means and infrastructures providing security services, existing, or specified advanced solutions are described and compared. In that context, the Electronic Health Record as e-health core application has been especially considered. Based on published work as well as on explored solutions, the security services needed are summarised and evaluated. The pros and cons of investigated examples are collected and interpreted. In that context, especially the German health telematics framework architecture and security infrastructure and the corresponding implementable solutions on the one hand and the USA Veterans Health Administration approach to security have been carefully considered. CONCLUSION: Processes and systems are determined by policies, which define and distinguish constraints for communication and collaboration. Therefore, formally modelling policies and performing policy bridging are the main challenges to be met. As result of investigations, recommendations have been derived for establishing the trustworthiness required for any e-health solution at different level from regional to national, European, and even global scale, which are included in the conference summary.

Computer Security↗
PubMed2006

End-to-end security in telemedical networks--a practical guideline.

The interconnection of medical networks in different healthcare institutions will be constantly increasing over the next few years, which will require concepts for securing medical data during transfer, since transmitting patient related data via potentially insecure public networks is considered a violation of data privacy. The aim of our work was to develop a model-based approach towards end-to-end security which is defined as continuous security from point of origin to point of destination in a communication process. We show that end-to-end security must be seen as a holistic security concept, which comprises the following three major parts: authentication and access control, transport security, as well as system security. For integration into existing security infrastructures abuse case models were used, which extend UML use cases, by elements necessary to describe abusive interactions. Abuse case models can be constructed for each part mentioned above, allowing for potential security risks in communication from point of origin to point of destination to be identified and counteractive measures to be directly derived from the abuse case models. The model-based approach is a guideline to continuous risk assessment and improvement of end-to-end security in medical networks. Validity and relevance to practice will be systematically evaluated using close-to-reality test networks as well as in production environments.

Access to Information↗