Maria Hägglund, Therese Scott Duncan, Josefin Hagström, Sari Kujala, Anna Dudkina, Jonas Moll, Anna Kharko, Monika A Johansen, Charlotte Blease
{"title":"Adult Proxy Online Record Access - Differences Across Four Countries.","authors":"Maria Hägglund, Therese Scott Duncan, Josefin Hagström, Sari Kujala, Anna Dudkina, Jonas Moll, Anna Kharko, Monika A Johansen, Charlotte Blease","doi":"10.3233/SHTI251530","DOIUrl":"https://doi.org/10.3233/SHTI251530","url":null,"abstract":"<p><p>Patients' online record access (ORA) enables patients to involve their informal caregivers in care management by sharing health information, either through proxy access functionality or informally. The European Health Data Space mandates that member countries should ensure that patients can assign a proxy to have online access to their health data. In this study, we aimed to explore the current state of proxy ORA in four countries with mature ORA implementations; Sweden, Norway, Finland, and Estonia. We identified three types of proxy ORA; full proxy ORA, no proxy ORA, and controlled proxy ORA. Further guidance on ethically sound and secure proxy ORA functionality that complies with national and EU regulations and policies is warranted to ensure equal rights for citizens across Europe.</p>","PeriodicalId":94357,"journal":{"name":"Studies in health technology and informatics","volume":"332 ","pages":"216-220"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215067","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}
Adriano Tramontano, Arriel Benis, Catherine Chronaki, Gora Datta, Anne Moen, Silje Havrevold Henni, Maria João Feio, Oscar Tamburis
{"title":"On the Design of a FAIR Data Maturity Model for OneAquaHealth.","authors":"Adriano Tramontano, Arriel Benis, Catherine Chronaki, Gora Datta, Anne Moen, Silje Havrevold Henni, Maria João Feio, Oscar Tamburis","doi":"10.3233/SHTI251544","DOIUrl":"https://doi.org/10.3233/SHTI251544","url":null,"abstract":"<p><p>The scope of this work is to describe the overall process of assessing the compliance of the main Digital Objects produced in the OneAquaHealth project with the FAIR principles (Findability, Accessibility, Interoperability, and Reusability) via a custom FAIR Data Maturity Model. The model was designed and developed according to the project features, and in according with the One Digital Health Framework. Its goal is also to provide a tool characterized by a solid educational ground, so as to set the foundation of a timely FAIRification process for the next project steps.</p>","PeriodicalId":94357,"journal":{"name":"Studies in health technology and informatics","volume":"332 ","pages":"278-282"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215075","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}
Susan J Oudbier, Denise L Rodenburg, Linda W P Peute
{"title":"Development of a Visual Questionnaire for Evaluating Usability in Health Technologies.","authors":"Susan J Oudbier, Denise L Rodenburg, Linda W P Peute","doi":"10.3233/SHTI251536","DOIUrl":"https://doi.org/10.3233/SHTI251536","url":null,"abstract":"<p><p>Traditional usability questionnaires include complex terminology and abstract technical phrasing, making them inappropriate to individuals with limited digital (health) literacy. As a result, these people are underrepresented in evaluations of digital health technologies (DHTs) in a home setting, leading to feedback that does not adequately reflect their needs and experiences. Ultimately, this contributes to the development of technologies that may not be fully accessible, usable, or effective for all users. To address this gap, a visually enhanced usability questionnaire was co-produced with people living with dementia and students. The resulting card-deck can be applied to support the conversation and evaluation of DHT for individuals with lower digital (health) literacy. Further research is needed to determine whether this visual tool effectively improves their representation and contributes to more equitable assessments of DHTs in practice.</p>","PeriodicalId":94357,"journal":{"name":"Studies in health technology and informatics","volume":"332 ","pages":"242-246"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215092","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}
Thomas Karopka, Carina Østervig Byskov, Martin Dyrba
{"title":"Evaluation of Clinical AI-Based Diagnostic Solutions - A Multiperspective, Interdisciplinary Approach.","authors":"Thomas Karopka, Carina Østervig Byskov, Martin Dyrba","doi":"10.3233/SHTI251485","DOIUrl":"https://doi.org/10.3233/SHTI251485","url":null,"abstract":"<p><strong>Introduction: </strong>The primary goal of developing new clinical diagnostic solutions is to create value for healthcare. The rapid rise of artificial intelligence (AI)-based diagnostics has led to a surge in publications and, to a lesser extent, market-ready tools. Clinicians must now integrate these innovations to manage increasing data volumes, making it challenging to assess the added value of new tools in the diagnostic workflow.</p><p><strong>Methods: </strong>The INTERREG Baltic Sea Region project \"Clinical Artificial Intelligence-Based Diagnostics (CAIDX)\" developed a comprehensive blueprint guiding the process from identifying clinical needs to implementing certified AI products in diagnostics. The approach emphasizes systematic evaluation at each development stage and throughout the AI solution's lifecycle, incorporating diverse stakeholder perspectives and a range of evaluation methodologies.</p><p><strong>Results: </strong>The CAIDX project produced the \"Clinical AI-Pathway,\" an end-to-end framework for integrating AI-based diagnostic tools. This framework provides methodologies and tools for systematic evaluation at all stages, ensuring alignment with clinical needs and rigorous assessment of value.</p><p><strong>Conclusions: </strong>Systematic, multi-perspective evaluation is crucial for successfully integrating AI diagnostics into clinical practice. The \"Clinical AI-Pathway\" framework offers a structured method for assessing and implementing AI solutions, supporting their value-driven adoption in healthcare. The framework, available at ClinicalAI.eu, aims to facilitate broader and more effective use of AI in clinical diagnostics.</p>","PeriodicalId":94357,"journal":{"name":"Studies in health technology and informatics","volume":"332 ","pages":"7-11"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215096","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}
Dorian Zwanzig, Luca Kreibich, Uta Binder, Ute Dietrich
{"title":"Evaluating AI-Powered Q&A Systems: A Simple Approach to Determining the Need for Expert Ratings.","authors":"Dorian Zwanzig, Luca Kreibich, Uta Binder, Ute Dietrich","doi":"10.3233/SHTI251532","DOIUrl":"https://doi.org/10.3233/SHTI251532","url":null,"abstract":"<p><p>This paper introduces a simple approach for assessing whether laypeople or AI-based automations can adequately substitute for expert ratings in the evaluation of AI-powered Q&A systems It employs weighted Cohen's Kappa to assess inter-rater reliability, establishing an expert agreement benchmark and comparing this to individual alternative rater-expert agreements. By visualizing these results in an inter-rater reliability matrix, it is a transparent and structured way to determine the adequacy of non-expert raters. Our findings, based on a real project, suggest that laypeople or AI, in some cases, can match or exceed expert agreement, particularly when risk aversion is a factor. The approach can be adapted to different contexts and rating attributes.</p>","PeriodicalId":94357,"journal":{"name":"Studies in health technology and informatics","volume":"332 ","pages":"222-226"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215107","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}
{"title":"Implementing a Cost-Efficient and Interoperable Health Data Infrastructure: A Multi-Region Finnish Case Study.","authors":"Sanna Virkkunen, Tuomas Granlund, Risto Kaikkonen","doi":"10.3233/SHTI251507","DOIUrl":"https://doi.org/10.3233/SHTI251507","url":null,"abstract":"<p><p>This paper examines a large-scale, collaborative data infrastructure project implemented across three Finnish wellbeing services counties in response to national health reform mandates. Using a qualitative case study approach and the European Interoperability Framework (EIF), this paper analyzes how organizational, political, semantic, and technical interoperability were jointly managed to develop standardized yet distributed data lake solutions. While legislative obligations drove the collaboration, success required close operational coordination, agile methods, and shared technical frameworks. By deploying parallel yet aligned environments, the counties achieved standardized reporting, reduced duplication, and improved cost-efficiency. The case highlights that sustainable digital health reform demands a holistic approach integrating top-down mandates with localized coordination and technical agility, ensuring all EIF dimensions are consistently addressed. Future evaluations should assess the long-term cost-effectiveness, scalability, and governance sustainability of this standardized, distributed model.</p>","PeriodicalId":94357,"journal":{"name":"Studies in health technology and informatics","volume":"332 ","pages":"113-117"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215123","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}
Nina Cassandra Wiegers, Sebastian Germer, Christiane Rudolph, Natalie Rath, Katharina Rausch, Alexander Katalinic, Heinz Handels
{"title":"Evaluating Imputation Techniques for Survival Data Utilizing Kaplan-Meier Curves.","authors":"Nina Cassandra Wiegers, Sebastian Germer, Christiane Rudolph, Natalie Rath, Katharina Rausch, Alexander Katalinic, Heinz Handels","doi":"10.3233/SHTI251487","DOIUrl":"https://doi.org/10.3233/SHTI251487","url":null,"abstract":"<p><p>Cancer registries collect data about cancer patients, such as information about the tumor histology and progress, but tend to be incomplete in some variables, which complicates further analysis like survival probabilities. Imputation can benefit these analyses. Most imputation methods aim to learn the underlying data distribution of the available data, but often only feature-wise errors are evaluated. In this paper a new approach to evaluate the learned data distribution in case of survival analysis for two state-of-the-art imputation methods is presented. To estimate the survival probability after a cancer diagnosis Kaplan-Meier (KM) curves are used and calculated for survival cohorts. Stratifying the data using the UICC tumor stadium, we aim to evaluate the imputation quality using the comparison of the survival time probability. Two KM curves are calculated for each UICC-stage, while one curve is based on the survival time of the known UICC-stage and the other is computed for the survival times of the imputed UICC-stages. Differences in KM curves will be tested with a log-rank test, a modified Manhattan-Distance and the maximum absolute distance. The best result for all evaluation metrics is achieved for the UICC-stage II, which was imputed with the imputer Miss Forest and aligns well with the qualitative result of the plotted KM curves. Especially for the survival analysis the proposed metrics can help epidemiological researchers to choose an imputation method, which can preserve the trend of the survival probabilities.</p>","PeriodicalId":94357,"journal":{"name":"Studies in health technology and informatics","volume":"332 ","pages":"17-21"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215169","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}
Somayeh Abedian, Eugene Yesakov, Stanislav Ostrovskiy, Rada Hussein
{"title":"Integrating Garmin Wearable Data into FHIR-Based Health Systems for Improved Interoperability.","authors":"Somayeh Abedian, Eugene Yesakov, Stanislav Ostrovskiy, Rada Hussein","doi":"10.3233/SHTI251523","DOIUrl":"https://doi.org/10.3233/SHTI251523","url":null,"abstract":"<p><p>As wearable technologies become more common in everyday life, integrating Patient-Generated Health Data (PGHD) into clinical systems has emerged as a critical area in digital health. This study explores how data such as heart rate, step count, sleep patterns, and activity levels (captured in this study via the Garmin Vívoactive 4 smartwatch) can be brought into FHIR-based healthcare systems through the Fitrockr platform. We explore how these data align with key Fast Healthcare Interoperability Resources (FHIR), such as Observation, Device, and Patient. Additionally, we evaluate the compatibility of collected datasets by the Modular Open Research Environment (MORE) platform with FHIR and examine the feasibility of transferring these records to FHIR servers. This level of semantic interoperability could simplify the integration of PGHD into hospital information systems or other healthcare information systems and especially EHRs, thus enhancing their contribution to care delivery, especially in medical decision making and as a source for Clinical Decision Support Systems (CDSS). The paper also discusses how standards like FHIR, openEHR, and Observational Medical Outcomes Partnership (OMOP) can work together to ensure consistent, meaningful integration of wearable data for both clinical practice and secondary analysis. In summary, we reflect on the importance of real-time wearable data availability, reliability, and privacy in supporting a more personalized, data-driven healthcare experience.</p>","PeriodicalId":94357,"journal":{"name":"Studies in health technology and informatics","volume":"332 ","pages":"185-189"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215090","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}
{"title":"Transforming Rehabilitation: Physiotherapy Students' Expectations on Electronic Health Information Systems and Digital Services.","authors":"Venla Karikumpu, Marja Äijö, Tuulikki Vehko, Ulla-Mari Kinnunen, Virpi Jylhä","doi":"10.3233/SHTI251516","DOIUrl":"https://doi.org/10.3233/SHTI251516","url":null,"abstract":"<p><p>Digitalisation is one of the transforming forces in rehabilitation. This study aims to describe physiotherapy students' perceptions of digital documentation, their expectations of using electronic health information systems (HIS), and the transformation of digital services in rehabilitation work. Two workshops for second-year physiotherapy students were performed. The workshop participants (n = 40) wrote their responses in small groups on a digital research platform. The inductive content analysis was applied to data analysis. Three main themes emerged for expectations of HIS: system, environmental, and individual factors. Further, the expectations for the transformation of digital services were categorized into three main themes: the possibility of service quality deterioration, improvement of service quality, and changes in operational culture. In conclusion, physiotherapy students identified meaningful features of HIS that affect rehabilitation, with key expectations of digitalisation around service quality and operational culture. Placing technology adoption within the future user's context provides valuable insights for transforming rehabilitation.</p>","PeriodicalId":94357,"journal":{"name":"Studies in health technology and informatics","volume":"332 ","pages":"154-158"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215093","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}
{"title":"Why SNOMED CT Fails to Succeed. A Medical Perspective on Health Informatics.","authors":"Petter Hurlen","doi":"10.3233/SHTI251553","DOIUrl":"https://doi.org/10.3233/SHTI251553","url":null,"abstract":"<p><p>This paper addresses the lack of evidence-based Health informatics, using SNOMED CT as an example. After 60 years, there is still no evidence that SNOMED CT provides benefits to individual patients and no evidence that it can replace the medical languag safely. The terminology assumes that medical concepts are universal, stable and autonomous. This does not apply to the clinical understanding of diseases and diagnoses as found in evidence-based medicine, possibly explaining the lack of success. SNOMED CT should be used with caution and not replace professional languages in clinical work without evidence.</p>","PeriodicalId":94357,"journal":{"name":"Studies in health technology and informatics","volume":"332 ","pages":"315-319"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215124","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}