Medical informatics = Medecine et informatique最新文献_第8页

Diabetes intervention in the information age. 信息时代的糖尿病干预。

Medical informatics = Medecine et informatique Pub Date : 1996-10-01 DOI: 10.3109/14639239608999291

A M Albisser, R I Harris, S Sakkal, I D Parson, S C Chao

{"title":"Diabetes intervention in the information age.","authors":"A M Albisser, R I Harris, S Sakkal, I D Parson, S C Chao","doi":"10.3109/14639239608999291","DOIUrl":"https://doi.org/10.3109/14639239608999291","url":null,"abstract":"Sustained improvement in blood glucose control is the only treatment outcome which will reduce or eliminate the long term complications of diabetes mellitus. We have designed and evaluated an electronic information system which facilitates this task. The system is voice-interactive, physician directed and affords, to remote patients, 24 h access via touch-tone telephone. Accordingly, patients access the system each day to report self-measured blood glucose levels or hypoglycaemic symptoms together with dietary changes, planned exercise, stress, illness or other lifestyle events. In turn they receive immediate advice with respect to medication dosing changes, and other pertinent feedback. Preliminary system beta-testing for safety and efficacy was performed for one year in an open study of 204 patients derived from two independent, health-care environments. Among the two testing centres, over 60,000 telephone cells were received by the computer systems during the start-up year. Safety and efficacy expectations were met. In addition, prevalence of diabetes related crises (hyperglycaemia or hypoglycaemia) fell approximately 3-fold. Glycated haemoglobin fell significantly (1.0-1.3%) in patients actively using the system. In control groups of patients not actively using the system, there were no improvements in metabolic control while body weights were stable in all groups. The new system was safe and effective in our hands and empowered our health professionals to provide improved diabetes care.","PeriodicalId":76132,"journal":{"name":"Medical informatics = Medecine et informatique","volume":"21 4","pages":"297-316"},"PeriodicalIF":0.0,"publicationDate":"1996-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/14639239608999291","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20126430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 73

Insulin algorithms in the self-management of insulin-dependent diabetes: the interactive 'Apple Juice' program. 胰岛素依赖型糖尿病自我管理中的胰岛素算法:交互式“苹果汁”程序。

Medical informatics = Medecine et informatique Pub Date : 1996-10-01 DOI: 10.3109/14639239608999293

A G Williams

引用次数: 10

Terminology support for development of sharable knowledge modules. 共享知识模块开发的术语支持。

Medical informatics = Medecine et informatique Pub Date : 1996-07-01 DOI: 10.3109/14639239609025358

M Carlsson, H Ahlfeldt, A Thurin, O Wigertz

{"title":"Terminology support for development of sharable knowledge modules.","authors":"M Carlsson, H Ahlfeldt, A Thurin, O Wigertz","doi":"10.3109/14639239609025358","DOIUrl":"https://doi.org/10.3109/14639239609025358","url":null,"abstract":"Lack of an agreed infrastructure for terminology is identified as one of the major barriers to interchange of knowledge modules and integration of knowledge bases with other clinical information systems. The goal of the GALEN project is to bridge this gap between different terminology systems through the construction of a terminology server, which is based on a rich conceptual model with mapping facilities to natural language expressions and coding schemas. The long term goal is to support communication between medical information systems. Arden Syntax is a standard format for the creation of knowledge modules, with sharability as one of the main objectives. Since Arden Syntax is based on a data-driven approach, the data items used need to be adapted to locally available terminology. The GALEN approach appears to be complementary to Arden Syntax and to the development of sharable knowledge modules. The major theme of this paper is utilization of the GALEN terminology server for knowledge module authoring. Two systems are presented, a knowledge base manager and a client to the terminology server, allowing the user to navigate in the semantic network and to import concept definitions and terms into the knowledge modules. The benefit of the terminology server, allowing the user to navigate in the semantic network and to import concept definitions and terms into the knowledge modules. The benefit of the terminology services is discussed.","PeriodicalId":76132,"journal":{"name":"Medical informatics = Medecine et informatique","volume":"21 3","pages":"207-14"},"PeriodicalIF":0.0,"publicationDate":"1996-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/14639239609025358","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20020268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

Coding medical concepts: a controlled experiment with a computerized coding tool. 医学概念编码:用计算机编码工具进行的对照实验。

Medical informatics = Medecine et informatique Pub Date : 1996-07-01 DOI: 10.3109/14639239609025357

J H Hohnloser, F Pürner, P Kadlec

{"title":"Coding medical concepts: a controlled experiment with a computerized coding tool.","authors":"J H Hohnloser, F Pürner, P Kadlec","doi":"10.3109/14639239609025357","DOIUrl":"https://doi.org/10.3109/14639239609025357","url":null,"abstract":"In medicine there is a growing need to encode medical concepts with the available standard coding systems. The coding process can be time intensive and may significantly add to daily paperwork. We have developed a generic computerized encoding tool--the PADS (patient archiving and documentation system) encoder--to ensure rapid, correct and complete coding of diagnoses in daily routine. The tool is integrated into an electronic patient record system and takes full advantage of the user friendly Macintosh interface. The tool was tested in a controlled experiment by 18 clinicians who encoded a total of 666 medical concepts in each protocol (study protocol versus control). We present data demonstrating that a computerized coding tool can produce more complete data of higher quality and save time compared with the traditional approach: (a) the number of correctly encoded medical concepts was higher (99.55% versus 86.1%); (b) coding errors were lower (0% versus 10.81%); (c) more modifier codes were encoded correctly (increase by up to 43%); (d) fewer coding errors were made (decrease by up to 43%); (e) the overall rate of correctly encoded and complete main and modifier codes was increased by 31.27% (97.29% versus 66.02%); and (f) coding time was reduced by 50%.","PeriodicalId":76132,"journal":{"name":"Medical informatics = Medecine et informatique","volume":"21 3","pages":"199-206"},"PeriodicalIF":0.0,"publicationDate":"1996-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/14639239609025357","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20017818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Objective evaluation of two markers of HIV-1 infection (p24 antigen concentration and CD4+ cell counts) by a self organizing neural network. 目的利用自组织神经网络评价HIV-1感染的两种标志物(p24抗原浓度和CD4+细胞计数)。

Medical informatics = Medecine et informatique Pub Date : 1996-07-01 DOI: 10.3109/14639239609025359

M Giacomini, C Ruggiero, M Maillard, F B Lillo, O E Varnier

{"title":"Objective evaluation of two markers of HIV-1 infection (p24 antigen concentration and CD4+ cell counts) by a self organizing neural network.","authors":"M Giacomini, C Ruggiero, M Maillard, F B Lillo, O E Varnier","doi":"10.3109/14639239609025359","DOIUrl":"https://doi.org/10.3109/14639239609025359","url":null,"abstract":"The aim of the present work is to obtain groups of patients with similar profiles of p24 antigen concentration and of CD4+ cell counts. These two markers were chosen because their evaluation represents a significant step in the clinical follow up of HIV-1 infected subjects. The detection methods for p24 antigen concentration and for CD4+ cell counts are well assessed and guarantee easy reproducibility of data obtained in different laboratories. A set of observations with the same time intervals were derived from a continuous function obtained for each patient by a back-propagation neural net trained on the raw data from the patient. The classifications were obtained by a Kohonen neural net trained in three ways: with p24 antigen profiles only, with CD4+ cell count profiles only and with both sets of profiles. The results show that the clustering fashion of the two parameters closely resembles the clustering fashion of CD4+ only, rather than that of p24Ag, both with reference to cluster formation and with reference to distances between clusters.","PeriodicalId":76132,"journal":{"name":"Medical informatics = Medecine et informatique","volume":"21 3","pages":"215-28"},"PeriodicalIF":0.0,"publicationDate":"1996-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/14639239609025359","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20020269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

EDI system definition for a European medical device vigilance system. 欧洲医疗器械警戒系统的EDI系统定义。

Medical informatics = Medecine et informatique Pub Date : 1996-07-01 DOI: 10.3109/14639239609025361

G Doukidis, N Pallikarakis, G Pangalos, G Vassilacopoulos, K Pramataris

引用次数: 4

Computer-based clinical decision aids. A review of methods and assessment of systems. 基于计算机的临床决策辅助。对方法和系统评估的回顾。

Medical informatics = Medecine et informatique Pub Date : 1996-07-01 DOI: 10.3109/14639239609025356

Y Reisman

{"title":"Computer-based clinical decision aids. A review of methods and assessment of systems.","authors":"Y Reisman","doi":"10.3109/14639239609025356","DOIUrl":"https://doi.org/10.3109/14639239609025356","url":null,"abstract":"During the last three decades a great deal of research has been devoted to the development of integrated clinical decision support systems. This report aims to give a basic understanding of what is required for such a system. By means of a large literature study a survey is given of the major components of computer-based clinical aid systems. The main approaches and several aspects of evaluation of such programs are described. The computer has several inherent capabilities which are suitable for medical problem solving and can help in the formalization of medical knowledge. The components of such systems include the computer database, the reasoning engine and the user interface. The different approaches on which the reasoning engine is built are based on manipulation of information and advocate the use of knowledge to construct a solution to a problem. The information in the mode vary from data-intensive to knowledge-intensive. Assessment of decision support systems is a very important phase in the development of such systems. Evaluation should be made on the accuracy of the program, the nature of the system, the use of the data and the acceptance by the target users. Whatever the model is, its effectiveness will depend on the data with which the program has to work. Acceptance by physicians depends among other things on ease of use of the user interface. Profound changes in the delivery of health care will be induced through the rapid growth of on-line computer communication together with the development of integrated clinical decision support systems and electronic medical records. Notwithstanding the rapid growth of computer technology, computer-aided decision making is in its infancy and real support in daily practice is not yet achieved.","PeriodicalId":76132,"journal":{"name":"Medical informatics = Medecine et informatique","volume":"21 3","pages":"179-97"},"PeriodicalIF":0.0,"publicationDate":"1996-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/14639239609025356","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20017817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 42

Type of distribution of the test data of the optokinetic nystagmus. 眼动性震颤试验数据的分布类型。

Medical informatics = Medecine et informatique Pub Date : 1996-07-01 DOI: 10.3109/14639239609025362

Y Chiba, N Furuya

{"title":"Type of distribution of the test data of the optokinetic nystagmus.","authors":"Y Chiba, N Furuya","doi":"10.3109/14639239609025362","DOIUrl":"https://doi.org/10.3109/14639239609025362","url":null,"abstract":"In statistical analysis, the type of distribution of the population under study dictates the choice of analytical methods. Exploratory data analysis was undertaken to evaluate the type of distribution for several variables in optokinetic nystagmus: the total numbers of nystagmus (NYS), the algebraic sums of the slow-phase amplitude (AMP) and of the slow-phase velocity (VEL), and the means of the fast-phase velocity (FM). The samples were collected from 814 healthy subjects as reference data. The 5-number summaries were first calculated for each variable, and the mid-summaries for the six letter values were examined for fine structure to reveal the presence of some outliers. The upper and lower limits of the 5-number summaries were then defined to reject the outliers. After outlier rejection the distribution was examined by histogram and probability plots, and by evaluation with the chi-square test, the Kolomogorov-Smirnov test and also with skewness and kurtosis. All the variables proved to fit the normal distribution by at least three methods, except by skewness and kurtosis. Of all methods, the probability plot seems to be the best in the present evaluation.","PeriodicalId":76132,"journal":{"name":"Medical informatics = Medecine et informatique","volume":"21 3","pages":"245-52"},"PeriodicalIF":0.0,"publicationDate":"1996-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/14639239609025362","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20018280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Searching for risk factors using multilayer neural network as a classifier. 利用多层神经网络作为分类器搜索危险因素。

Medical informatics = Medecine et informatique Pub Date : 1996-07-01 DOI: 10.3109/14639239609025360

H Xue, N Tatsumi, K Park, M Shimizu, T Kyojima, Y Sumiya, S Kawabata, N Maeda, D Sakano

引用次数: 2

Towards computer assisted evaluation of plagiocephaly. 斜头畸形的计算机辅助评价。

Medical informatics = Medecine et informatique Pub Date : 1996-04-01 DOI: 10.3109/14639239608995017

H A Donegan, D C O'Flaherty, W G Kernohan

引用次数: 5