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The patient online.

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Computer Communication Networks↗

Visualization and interactive analysis of blood parameters with InfoZoom.

This paper describes the application of the data analysis tool InfoZoom to a database containing the results of blood examinations for about 400 patients with a suspect of thrombosis. The main goal was to find correlations between the measurements and the occurrence of a thrombosis. No automatic method for data mining is used. Instead, InfoZoom uses a novel technique to display data sets as highly compressed tables which always fit completely onto the screen. The user can interactively explore animated tabular views of the data. In this way, the user gets a feeling of the data, detects interesting knowledge, and gains a deep understanding of the data set.

Databases, Factual↗

A formal framework of knowledge to support rational psychoactive drug selection.

Rational psychoactive drug selection is a data and knowledge intensive task which requires true expertise from clinical, pathophysiological and pharmacotherapeutic knowledge. This paper presents a framework of knowledge, which relates concepts from several disciplines required for psychoactive drug selection in a formal way. A framework, when based on formal semantics, avoids ambiguity and gives conceptual clarity and supports precise use of terminology which is required when many domain experts (clinicians, pharmacologists and basic science researchers) are involved. A formal framework permits linking of existing classification systems. It furthermore can serve as a knowledge base for drug selection decision support systems.

Artificial Intelligence↗

Machine learning for medical diagnosis: history, state of the art and perspective.

The paper provides an overview of the development of intelligent data analysis in medicine from a machine learning perspective: a historical view, a state-of-the-art view, and a view on some future trends in this subfield of applied artificial intelligence. The paper is not intended to provide a comprehensive overview but rather describes some subareas and directions which from my personal point of view seem to be important for applying machine learning in medical diagnosis. In the historical overview, I emphasize the naive Bayesian classifier, neural networks and decision trees. I present a comparison of some state-of-the-art systems, representatives from each branch of machine learning, when applied to several medical diagnostic tasks. The future trends are illustrated by two case studies. The first describes a recently developed method for dealing with reliability of decisions of classifiers, which seems to be promising for intelligent data analysis in medicine. The second describes an approach to using machine learning in order to verify some unexplained phenomena from complementary medicine, which is not (yet) approved by the orthodox medical community but could in the future play an important role in overall medical diagnosis and treatment.

Artificial Intelligence↗

Computerised controllers for safety critical medical applications.

A novel design for a computer control system to be employed in safety critical applications, as found in medical environments, is presented. It features a low complexity, fault detecting hardware architecturally supporting a strictly cyclic operating mode, as known from programmable logic controllers, and a specification level, graphical programming technique based on the interconnection of application oriented standard software function modules. By design, there is no semantic gap between the programming and machine execution levels. Thus enabling the safety licensing of application software by an extremely simple but rigorous method, the software verification problem is satisfactorily solved for a large application area, where failures may cause hazards to, or even loss of, human safety and lives.

Computer Systems↗

An intelligent tele-healthcare environment offering person-centric and wellness-maintenance services.

Worldwide healthcare delivery trends are undergoing a subtle paradigm shift--patient centered services as opposed to provider centered services and wellness maintenance as opposed to illness management. In this paper we present a Tele-Healthcare project TIDE--Tele-Healthcare Information and Diagnostic Environment. TIDE manifests an 'intelligent' healthcare environment that aims to ensure lifelong coverage of person-specific health maintenance decision-support services--i.e., both wellness maintenance and illness management services--ubiquitously available via the Internet/WWW. Taking on an all-encompassing health maintenance role--spanning from wellness to illness issues--the functionality of TIDE involves the generation and delivery of (a) Personalized, Pro-active, Persistent, Perpetual, and Present wellness maintenance services, and (b) remote diagnostic services for managing noncritical illnesses. Technically, TIDE is an amalgamation of diverse computer technologies--Artificial Intelligence, Internet, Multimedia, Databases, and Medical Informatics--to implement a sophisticated healthcare delivery infostructure.

Artificial Intelligence↗

The impact of information technology on histopathology.

Pathology is one of the most computer intensive areas of medicine and as a result diagnostic pathologists in histopathology have often been at the cutting edge of computer literacy. The majority of laboratories use laboratory information systems to issue and store pathology reports. Many of these systems provide the diagnostician with the ability to retrieve reports and cases using coding systems such as SNOMED, but more advanced computer facilities that might assist the pathologist in the diagnosis or interpretation of a case are often lacking. In recent years advances in computer technology have begun to have a much wider impact on the practice of medicine and newer technologies are beginning to find their way into the reporting room. In this review, I cover some of the recent and emerging advances in IT that have the potential to revolutionize the practice of diagnostic histopathology in the next 5 years. The major area of telepathology has been a subject of several recent reviews and will not be covered here.

Databases, Factual↗

Practical applications of hand-held computers in dermatology.

For physicians, hand-held computers are gaining popularity as point of care reference tools. The convergence of hand-held computers, the Internet, and wireless networks will enable these devices to assume more essential roles as mobile transmitters and receivers of digital medical Information. In addition to serving as portable medical reference sources, these devices can be Internet-enabled, allowing them to communicate over wireless wide and local area networks. With enhanced wireless connectivity, hand-held computers can be used at the point of patient care for charge capture, electronic prescribing, laboratory test ordering, laboratory result retrieval, web access, e-mail communication, and other clinical and administrative tasks. Physicians In virtually every medical specialty have begun using these devices in various ways. This review of hand-held computer use in dermatology illustrates practical examples of the many different ways hand-held computers can be effectively used by the practicing dermatologist.

Computers, Handheld↗

Virtual reality for health care: the status of research.

As information technology has advanced and costs have declined over the past decade, there has been a steady growth in the use of virtual reality (VR) in health care. According to the data of the two leading clinical databases--MEDLINE and PSYCINFO--the research in the virtual reality field is moving fast: under the "virtual reality" keyword, there are 739 papers listed in MEDLINE and 569 in PSYCINFO (accessed 6 December 2001). Much of this growth, however, has been in the form of feasibility studies and pilot trials. In fact, many researchers tried to use VR, but only a few were able to deepen their study. According to MEDLINE, only 16 research groups published more than three papers related to health care applications of VR. This number lowers to 12 for papers included in PSYCLIT. Therefore, apart from surgical training and some behavioral treatments, there is little convincing evidence coming from controlled studies of the clinical and economical advantages of this approach. This paper discusses recent evidence and outlines some guidelines for future research in this area.

Delivery of Health Care↗

A PIL for every ill? Patient information leaflets (PILs): a review of past, present and future use.

This article reviews the usefulness and importance of written information, specifically leaflets, being given to patients. Evidence suggesting how both patient and doctor may benefit from the giving of written information is reviewed. Identification of good practice relating to the content and readability of leaflets is discussed. An argument is put forward that the giving of written information is an under-utilized resource in contributing to improving patient outcomes but that this may be changing with the increasing use of patient leaflet databases. The advantages and disadvantages of computer-generated patient leaflets are discussed and desirable further areas of research on computer-generated leaflets are proposed.

Computers↗

Introduction.

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Biomedical Research↗

Computer instruction as part of a course on analytic medicine for first-year students.

The Medical University of South Carolina integrated instruction in information science and computer technology into a required freshman-level course. Analytic and Community Medicine. The advantages of this placement in the curriculum are two-fold. First, the course provides an opportunity to integrate computer methodology with clinically relevant topics such as medical decision-making. This integration enhances the students' view of the computer as a useful tool that can aid the physician in the practice of medicine. Course organizers are convinced that the success of the first offering is attributable to this integration. Second, the instruction comes early in the medical education process and allows the concepts learned to be utilized throughout the students' medical school careers. The degree to which these concepts and methods are actually utilized by students will depend upon the degree of reinforcement of these ideas in the clinical years and residency. Thus, faculty members must act as role models who not only acknowledge the importance of mastering the use of computers in medicine but also manifest those skills.

Community Medicine↗