Studies in health technology and informatics最新文献

Mechanism for Universal Smart Contracts: Towards Blockchain Interoperability in Health Systems. 通用智能合约机制：实现卫生系统区块链互操作性。

Studies in health technology and informatics Pub Date : 2025-10-02 DOI: 10.3233/SHTI251557

Edgar Dulce, Julio Hurtado, Jose Garcia-Alonso

{"title":"Mechanism for Universal Smart Contracts: Towards Blockchain Interoperability in Health Systems.","authors":"Edgar Dulce, Julio Hurtado, Jose Garcia-Alonso","doi":"10.3233/SHTI251557","DOIUrl":"https://doi.org/10.3233/SHTI251557","url":null,"abstract":"Interoperability between blockchain platforms remains a key challenge, particularly in sensitive domains such as healthcare, where the secure and consistent exchange of clinical information between institutions is essential. While technical interoperability solutions exist, semantic interoperability at the level of smart contracts continues to be a significant limitation. This paper presents MUISCA, a mechanism based on Model-Driven Engineering that enables the automatic generation of interoperable smart contracts across different blockchain platforms. By defining metamodels, abstract models, and transformation rules, MUISCA produces platform-specific code for technologies such as Ethereum and Hyperledger Fabric. The mechanism was validated through a healthcare case study focused on patient transfers between medical institutions, demonstrating its ability to support the secure exchange of clinical data. Additionally, its acceptance was evaluated through expert surveys assessing perceived usefulness and ease of use. Results show that MUISCA improves smart contract portability, reduces implementation errors, and enhances system security. The proposed solution contributes to advancing semantic interoperability in blockchain-based health information systems and provides a foundation for broader application in other critical domains that require high levels of integration and data protection.","PeriodicalId":94357,"journal":{"name":"Studies in health technology and informatics","volume":"332 ","pages":"335-339"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215087","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: 0

Enhancing Medication Adherence Through Behavioral Nudging: Potentials of a Smartphone App-Based Approach. 通过行为推动提高药物依从性：基于智能手机应用程序的方法的潜力。

Studies in health technology and informatics Pub Date : 2025-10-02 DOI: 10.3233/SHTI251506

Andi Ademi, Andy Landolt, Murat Sariyar

{"title":"Enhancing Medication Adherence Through Behavioral Nudging: Potentials of a Smartphone App-Based Approach.","authors":"Andi Ademi, Andy Landolt, Murat Sariyar","doi":"10.3233/SHTI251506","DOIUrl":"https://doi.org/10.3233/SHTI251506","url":null,"abstract":"Poor medication adherence remains a persistent challenge in healthcare, significantly impacting treatment outcomes and healthcare costs. While reminders and education have shown limited success, recent developments in behavioral economics suggest that subtle interventions, known as \"nudges\", can influence patient behavior more effectively. This paper presents the design, development, and initial evaluation of a smartphone application aimed at improving medication adherence through nudging techniques and interactive features. The app combines behavioral design principles with human-centered development to offer functions such as context-aware reminders, a social avatar interface (Adii), symptom and appointment tracking, and customizable scheduling. Nudging strategies include default settings, motivational prompts, social reinforcement, and salience through feedback mechanisms. The app's structure was co-designed with healthcare stakeholders, informed by literature and market analysis, and implemented using React Native for cross-platform compatibility. A two-phase usability study with 16 participants revealed that default schedules and visual feedback significantly influenced adherence behaviors. Personalized reminders and the avatar enhanced emotional engagement, while onboarding ease and offline support improved user trust. Though still in prototype phase, the app demonstrates promising utility for long-term adherence improvement. Future versions aim to incorporate adaptive nudging based on AI-driven user behavior modeling.","PeriodicalId":94357,"journal":{"name":"Studies in health technology and informatics","volume":"332 ","pages":"108-112"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215094","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: 0

Evaluating Privacy and Utility in Synthetic EHR Data Generation for Adverse Drug Event Detection. 评估药物不良事件检测合成电子病历数据生成的隐私性和效用。

Studies in health technology and informatics Pub Date : 2025-10-02 DOI: 10.3233/SHTI251490

Thu Dinh, Hercules Dalianis

引用次数: 0

Towards GraphQL-Based Interoperability Between Business Meta-Models and FHIR Resources. 实现业务元模型与FHIR资源之间基于graphql的互操作性。

Studies in health technology and informatics Pub Date : 2025-10-02 DOI: 10.3233/SHTI251526

Elis Saarelaid, Rainer Randmaa, Gunnar Piho, Peeter Ross

引用次数: 0

"Digital Unless?" Evaluating Digital Transformation in a Dutch Hospital. “数字除非?”评估荷兰医院的数字化转型。

Studies in health technology and informatics Pub Date : 2025-10-02 DOI: 10.3233/SHTI251510

Felix Cillessen, Sanne van Logten, Jacob Hofdijk

{"title":"\"Digital Unless?\" Evaluating Digital Transformation in a Dutch Hospital.","authors":"Felix Cillessen, Sanne van Logten, Jacob Hofdijk","doi":"10.3233/SHTI251510","DOIUrl":"https://doi.org/10.3233/SHTI251510","url":null,"abstract":"Facing rising care demands, workforce shortages, and cost pressures, healthcare systems increasingly view digital transformation as essential rather than optional. This paper presents a qualitative evaluation of such efforts within a Dutch hospital that formally embraced the \"digital unless\" principle, providing care digitally by default unless not feasible. Despite strategic commitment, actual implementation often lags behind due to organizational, cultural, and practical barriers. In April 2025, a structured internal session was held involving a diverse group of stakeholders, including the executive board, board of medical staff, nursing staff board, tactical management representatives, the innovation committee, CMIO, CIO, and the patient advisory council. The session included (1) a strategic proposition review, (2) a \"fishbowl\" dialogue focused on staff experience, and (3) a debate on patient needs and autonomy. Central questions included \"Are we doing digitally what can be done digitally?\" and \"What is needed to make that a reality?\" Thematic analysis of the session revealed five key lessons: (1) hybrid care is the realistic default; (2) mindset and working technology are interdependent; (3) tailored support for staff is critical; (4) adopting proven innovations from others is efficient and effective; and (5) patient autonomy must remain central. These findings are contextualized using current literature and implementation frameworks like the Technology-Organization-Environment (TOE) model. External sources provide empirical support for the operational, clinical, and human value of digital health. The study concludes that digital success depends less on vision and more on cultural readiness, staff alignment, and meaningful patient inclusion. This paper offers practical, evidence-informed recommendations to help hospitals translate digital ambitions into measurable impact.","PeriodicalId":94357,"journal":{"name":"Studies in health technology and informatics","volume":"332 ","pages":"128-132"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214789","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: 0

Risk Management in "Other Clinical Investigations" According to Art. 82 MDR - Lessons Learnt from the EDITh Project. 根据MDR第82条“其他临床研究”的风险管理-从EDITh计划中吸取的教训。

Studies in health technology and informatics Pub Date : 2025-10-02 DOI: 10.3233/SHTI251484

Ariadna Pérez Garriga, Stefan Wolking, Josua Kegele, Christian M Bosselmann, Beatrice Coldewey, Raphael W Majeed, Rainer Röhrig, Yvonne Weber, Myriam Lipprandt

{"title":"Risk Management in \"Other Clinical Investigations\" According to Art. 82 MDR - Lessons Learnt from the EDITh Project.","authors":"Ariadna Pérez Garriga, Stefan Wolking, Josua Kegele, Christian M Bosselmann, Beatrice Coldewey, Raphael W Majeed, Rainer Röhrig, Yvonne Weber, Myriam Lipprandt","doi":"10.3233/SHTI251484","DOIUrl":"https://doi.org/10.3233/SHTI251484","url":null,"abstract":"With the implementation of the EU Medical Device Regulation (MDR), clinical trials of clinical decision support systems (CDSS) now often fall under Article 82 of the MDR. This mandates systematic risk management even for academic feasibility studies. This article presents a risk management strategy based on the EDiTh project, which evaluated a CDSS for epilepsy treatment recommendations in accordance with the 2023 S2k guideline First epileptic seizure and epilepsy in adulthood. A Preliminary Hazard Analysis and System Failure Mode and Effects Analysis identified key error types such as incorrect diagnoses or dosing recommendations. Due to the potential for catastrophic harm, a dual-visit study design was implemented, including a second, blinded expert consultation via videoconference to independently confirm diagnosis and treatment decisions. This design supports both risk mitigation and assessment of guideline adherence as the primary endpoint. The risk matrix and study setup illustrate how safety and regulatory requirements can be met in academic environments, while offering insights for future MDR-compliant investigations of digital health technologies.","PeriodicalId":94357,"journal":{"name":"Studies in health technology and informatics","volume":"332 ","pages":"2-6"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214893","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: 0

Assessing Electromedical Device Obsolescence: A Comparison Between Linear and Fuzzy Logic Approaches. 评估电子医疗设备过时：线性和模糊逻辑方法的比较。

Studies in health technology and informatics Pub Date : 2025-10-02 DOI: 10.3233/SHTI251538

Andrea Adele Grassi, Simone Falco, Laura Oddera, Ezio Nicolàs Bruno Urbina, Mauro Giacomini

{"title":"Assessing Electromedical Device Obsolescence: A Comparison Between Linear and Fuzzy Logic Approaches.","authors":"Andrea Adele Grassi, Simone Falco, Laura Oddera, Ezio Nicolàs Bruno Urbina, Mauro Giacomini","doi":"10.3233/SHTI251538","DOIUrl":"https://doi.org/10.3233/SHTI251538","url":null,"abstract":"The focus of this study is the evaluation of electromedical devices through different methods of analysis, thanks to which it is possible to determine the obsolescence and therefore the need for decommissioning or revaluation of the same. The study has been conducted in parallel with the wave of renewal that is involving the IRCCS Giannina Gaslini Institute, particularly with the construction of the new Pavilion Zero, organized by intensity of care. This transformation requires a reorganization and awareness of all the existing medical equipment, along with the need for appropriate management, redistribution, and, in some cases, disposal. To support this process, the present study focuses on the evaluation of medical devices within the Institute, through the use of two different assessment methodologies: MVO (Obsolescence Evaluation Method) and a custom-developed index based on fuzzy logic. The analysis involved more than 8,000 devices. The first index (MVO) was developed by the company, which is responsible for maintaining medical devices within the Institute, namely Hospital Consulting S.p.A., which has used some objective parameters from the internal database. The second one was designed by the authors using the same parameters employed in the MVO, but was later refined through further analysis, which led to the exclusion or inclusion of parameters deemed crucial for the evaluation. This index was also developed with the support of some fuzzy logic based parameters. In the end, the two methodologies were compared in order to determine the consistency of the two methods used and the differences obtained.","PeriodicalId":94357,"journal":{"name":"Studies in health technology and informatics","volume":"332 ","pages":"252-256"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215070","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: 0

Quantification of Heterogeneous Semi-Structured Patient-Reported Physical Activities Derived from a Diabetes Telehealth Service. 来自糖尿病远程医疗服务的异构半结构化患者报告的身体活动的量化。

Studies in health technology and informatics Pub Date : 2025-10-02 DOI: 10.3233/SHTI251520

Fabian Wiesmüller, Martin Baumgartner, Florian Hoffmann, Mahdi Sareban, Gunnar Treff, Josef Niebauer, Günter Schreier, Dieter Hayn

{"title":"Quantification of Heterogeneous Semi-Structured Patient-Reported Physical Activities Derived from a Diabetes Telehealth Service.","authors":"Fabian Wiesmüller, Martin Baumgartner, Florian Hoffmann, Mahdi Sareban, Gunnar Treff, Josef Niebauer, Günter Schreier, Dieter Hayn","doi":"10.3233/SHTI251520","DOIUrl":"https://doi.org/10.3233/SHTI251520","url":null,"abstract":"Telehealth systems have shown to facilitate lifestyle changes like an increase in physical activity. Therefore, an easily quantifiable measure of physical activity levels for both assessing a patient's status quo and tracking physical activity development is needed. The aim of this work was to map semi-structured activities reported as type-intensity-duration triplets in the DiabMemory telehealth system to Metabolic Equivalents of Task (METs). The activity data of 947 telehealth patients were analyzed to create a mapping table between type-intensity pairs and MET values from a preexisting compendium. Additionally, the distribution of activity types and resulting MET scores was evaluated. Combining the MET scores with the duration resulted in the quantified activity measure (MET-minutes). A significant difference in the MET-minutes per activity type (p < 0.0001) was identified. In the future, our method of mapping semi-structured data to METs will serve as a support the evaluation of the effectiveness of DiabMemory.","PeriodicalId":94357,"journal":{"name":"Studies in health technology and informatics","volume":"332 ","pages":"170-174"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214791","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: 0

A Case Study to Explore Barriers and Facilitators to the Digitalization of Hospitals in Pakistan. 探索巴基斯坦医院数字化的障碍和促进因素的案例研究。

Studies in health technology and informatics Pub Date : 2025-10-02 DOI: 10.3233/SHTI251558

Ather Akhlaq, Muhammad Arsam Qazi, Owais Anwar Golra

引用次数: 0

Quantifying Epistemic Uncertainty in Predictions for Safer Health AI Performance Under Dataset Shifts. 量化数据集移位下更安全健康AI性能预测中的认知不确定性。

Studies in health technology and informatics Pub Date : 2025-10-02 DOI: 10.3233/SHTI251493

David Fernández-Narro, Pablo Ferri, Juan Miguel García-Gómez, Carlos Sáez

{"title":"Quantifying Epistemic Uncertainty in Predictions for Safer Health AI Performance Under Dataset Shifts.","authors":"David Fernández-Narro, Pablo Ferri, Juan Miguel García-Gómez, Carlos Sáez","doi":"10.3233/SHTI251493","DOIUrl":"https://doi.org/10.3233/SHTI251493","url":null,"abstract":"Out-of-distribution data , data coming from a different distribution with respect to the training data, entails a critical challenge for the robustness and safety of AI-based clinical decision support systems (CDSSs). This work aims to investigate whether real-time, sample-level quantification of epistemic uncertainty, the model's uncertainty due to limited knowledge of the true data-generating process, can act as a lightweight safety layer for health AI and CDSSs, targeting model updates and spotlighting human review. To this end, we trained and evaluated a continual learning-based neural network classifier on quarterly batches in a real-world Mexican COVID-19 dataset. For each training window, we estimated the distribution of the prediction epistemic uncertainties using Monte Carlo Dropout. We set a data-driven uncertainty threshold to determine potential out-of-distribution samples at 95% of that distribution. Results across all training-test time pairs show that samples below this threshold exhibit consistently higher macro-F1 and render performance virtually invariant to temporal drift, while the flagged samples captured most prediction errors. Since our method requires no model retraining, sample-level epistemic uncertainty screening offers a practical and efficient first line of defense for deploying health-AI systems in dynamic environments.","PeriodicalId":94357,"journal":{"name":"Studies in health technology and informatics","volume":"332 ","pages":"47-51"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214928","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: 0