| 1. |
- Ammenwerth, Elske, et al.
(författare)
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International Comparison of Six Basic eHealth Indicators Across 14 Countries: An eHealth Benchmarking Study
- 2020
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Ingår i: Methods of Information in Medicine. - : Georg Thieme Verlag KG. - 0026-1270 .- 2511-705X. ; 59:S2, s. e46-e63
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Tidskriftsartikel (refereegranskat)abstract
- Background Many countries adopt eHealth applications to support patient-centered care. Through information exchange, these eHealth applications may overcome institutional data silos and support holistic and ubiquitous (regional or national) information logistics. Available eHealth indicators mostly describe usage and acceptance of eHealth in a country. The eHealth indicators focusing on the cross-institutional availability of patient-related information for health care professionals, patients, and care givers are rare. Objectives This study aims to present eHealth indicators on cross-institutional availability of relevant patient data for health care professionals, as well as for patients and their caregivers across 14 countries (Argentina, Australia, Austria, Finland, Germany, Hong Kong as a special administrative region of China, Israel, Japan, Jordan, Kenya, South Korea, Sweden, Turkey, and the United States) to compare our indicators and the resulting data for the examined countries with other eHealth benchmarks and to extend and explore changes to a comparable survey in 2017. We defined "availability of patient data" as the ability to access data in and to add data to the patient record in the respective country. Methods The invited experts from each of the 14 countries provided the indicator data for their country to reflect the situation on August 1, 2019, as date of reference. Overall, 60 items were aggregated to six eHealth indicators. Results Availability of patient-related information varies strongly by country. Health care professionals can access patients most relevant cross-institutional health record data fully in only four countries. Patients and their caregivers can access their health record data fully in only two countries. Patients are able to fully add relevant data only in one country. Finland showed the best outcome of all eHealth indicators, followed by South Korea, Japan, and Sweden. Conclusion Advancement in eHealth depends on contextual factors such as health care organization, national health politics, privacy laws, and health care financing. Improvements in eHealth indicators are thus often slow. However, our survey shows that some countries were able to improve on at least some indicators between 2017 and 2019. We anticipate further improvements in the future.
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| 2. |
- Bayramoglu, Neslihan, et al.
(författare)
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Deep Learning for Predicting Progression of Patellofemoral Osteoarthritis Based on Lateral Knee Radiographs, Demographic Data and Symptomatic Assessments
-
Ingår i: Methods of Information in Medicine. - 0026-1270.
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Tidskriftsartikel (refereegranskat)abstract
- Objective: In this study, we propose a novel framework that utilizes deep learning and attention mechanisms to predict the radiographic progression of patellofemoral osteoarthritis (PFOA) over a period of seven years. Design: This study included subjects (1832 subjects, 3276 knees) from the baseline of the Multicenter Osteoarthritis Study (MOST). Patellofemoral joint regions-of interest were identified using an automated landmark detection tool (BoneFinder) on lateral knee X-rays. An end-to-end deep learning method was developed for predicting PFOA progression based on imaging data in a 5-fold cross-validation setting. To evaluate the performance of the models, a set of baselines based on known risk factors were developed and analyzed using gradient boosting machine (GBM). Risk factors included age, sex, BMI and WOMAC score, and the radiographic osteoarthritis stage of the tibiofemoral joint (KL score). Finally, to increase predictive power, we trained an ensemble model using both imaging and clinical data. Results: Among the individual models, the performance of our deep convolutional neural network attention model achieved the best performance with an AUC of 0.856 and AP of 0.431; slightly outperforming the deep learning approach without attention (AUC=0.832, AP= 0.4) and the best performing reference GBM model (AUC=0.767, AP= 0.334). The inclusion of imaging data and clinical variables in an ensemble model allowed statistically more powerful prediction of PFOA progression (AUC = 0.865, AP=0.447), although the clinical significance of this minor performance gain remains unknown. The spatial attention module improved the predictive performance of the backbone model, and the visual interpretation of attention maps focused on the joint space and the regions where osteophytes typically occur. Conclusion: This study demonstrated the potential of machine learning models to predict the progression of PFOA using imaging and clinical variables. These models could be used to identify patients who are at high risk of progression and prioritize them for new treatments. However, even though the accuracy of the models were excellent in this study using the MOST dataset, they should be still validated using external patient cohorts in the future.
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| 3. |
- Bång, Magnus, 1967-, et al.
(författare)
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Cognitive tools in medical teamwork : the spatial arrangement of patient records
- 2003
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Ingår i: Methods of Information in Medicine. - 0026-1270. ; 42:4, s. 331-336
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: As a preliminary for the design of Computer- Based Patient Records, the aim of this paper is to build an understanding of the roles physical artifacts like paper-based patient records play in support-ing cognition and collaboration in the healthcare settings. Method: A small ethnographically-informed study was conducted in the emergency room at a 250-bed hospital in Sweden from the perspective of Distributed Cognition. Results: To track work-in-progress, clinicians placed patient records on a desk to form a shared public display that represented the current problem state for the health-care team. The results of the study suggest that the patient records and other physical artifacts are used by clinicians in different ways to form cognitive tools that offload memory tasks and support joint attention and collaboration. Conclusion: To design Computer-Based Patient Records that more appropriately support cognition and teamwork, it is important to investigate how clinicians make use of the paper-based patient records. Practitioners take advantage of existing tools frequently to deal with cognitively demanding tasks and collaboration issues.
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| 4. |
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| 5. |
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| 6. |
- Cunningham, S. G., et al.
(författare)
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Core Standards of the EUBIRO Project Defining a European Diabetes Data Dictionary for Clinical Audit and Healthcare Delivery
- 2016
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Ingår i: Methods of Information in Medicine. - : Georg Thieme Verlag KG. - 0026-1270 .- 2511-705X. ; 55:2, s. 166-176
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Tidskriftsartikel (refereegranskat)abstract
- Background: A set of core diabetes indicators were identified in a clinical review of current evidence for the EUBIROD project. In order to allow accurate comparisons of diabetes indicators, a standardised currency for data storage and aggregation was required. We aimed to define a robust European data dictionary with appropriate clinical definitions that can be used to analyse diabetes outcomes and provide the foundation for data collection from existing electronic health records for diabetes. Methods: Existing clinical datasets used by 15 partner institutions across Europe were collated and common data items analysed for consistency in terms of recording, data definition and units of measurement. Where necessary, data mappings and algorithms were specified in order to allow partners to meet the standard definitions. A series of descriptive elements were created to document metadata for each data item, including recording, consistency, completeness and quality. Results: While datasets varied in terms of consistency, it was possible to create a common standard that could be used by all. The minimum dataset defined 53 data items that were classified according to their feasibility and validity. Mappings and standardised definitions were used to create an electronic directory for diabetes care, providing the foundation for the EUBIROD data analysis repository, also used to implement the diabetes registry and model of care for Cyprus. Conclusions: The development of data dictionaries and standards can be used to improve the quality and comparability of health information. A data dictionary has been developed to be compatible with other existing data sources for diabetes, within and beyond Europe.
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| 7. |
- Ethier, J-F., et al.
(författare)
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Clinical Data Integration Model : Core Interoperability Ontology for Research Using Primary Care Data
- 2015
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Ingår i: Methods of Information in Medicine. - 0026-1270 .- 2511-705X. ; 54:1, s. 16-23
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: This article is part of the Focus Theme of Methods of Information in Medicine on "Managing Interoperability and Complexity in Health Systems". Background: Primary care data is the single richest source of routine health care data. However its use, both in research and clinical work, often requires data from multiple clinical sites, clinical trials databases and registries. Data integration and interoperability are therefore of utmost importance. Objectives: TRANSFoRm's general approach relies on a unified interoperability frame-work, described in a previous paper. We developed a core ontology for an interoperability framework based on data mediation. This article presents how such an ontology, the Clinical Data Integration Model (CDIM), can be designed to support, in conjunction with appropriate terminologies, biomedical data federation within TRANSFoRm, an EU FP7 project that aims to develop the digital infrastructure for a learning healthcare system in European Primary Care. Methods: TRANSFoRm utilizes a unified structural /terminological interoperability framework, based on the local-as-view mediation paradigm. Such an approach mandates the global information model to describe the domain of interest independently of the data sources to be explored. Following a requirement analysis process, no ontology focusing on primary care research was identified and, thus we designed a realist ontology based on Basic Formal Ontology to support our framework in collaboration with various terminologies used in primary care. Results: The resulting ontology has 549 classes and 82 object properties and is used to support data integration for TRANSFoRm's use cases. Concepts identified by researchers were successfully expressed in queries using CDIM and pertinent terminologies. As an example, we illustrate how, in TRANSFoRm, the Query Formulation Workbench can capture eligibility criteria in a computable representation, which is based on CDIM. Conclusion: A unified mediation approach to semantic interoperability provides a flexible and extensible framework for all types of interaction between health record systems and research systems. CDIM, as core ontology of such an approach, enables simplicity and consistency of design across the heterogeneous software landscape and can support the specific needs of EHR-driven phenotyping research using primary care data.
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| 8. |
- Fernandez-Luque, Luis, et al.
(författare)
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Evidence-Based Health Informatics as the Foundation for the COVID-19 Response : A Joint Call for Action
- 2022
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Ingår i: Methods of Information in Medicine. - : Thieme Verlag. - 0026-1270 .- 2511-705X. ; 59:6, s. 183-192
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Tidskriftsartikel (refereegranskat)abstract
- Background As a major public health crisis, the novel coronavirus disease 2019 (COVID-19) pandemic demonstrates the urgent need for safe, effective, and evidence-based implementations of digital health. The urgency stems from the frequent tendency to focus attention on seemingly high promising digital health interventions despite being poorly validated in times of crisis. Aim In this paper, we describe a joint call for action to use and leverage evidence-based health informatics as the foundation for the COVID-19 response and public health interventions. Tangible examples are provided for how the working groups and special interest groups of the International Medical Informatics Association (IMIA) are helping to build an evidence-based response to this crisis. Methods Leaders of working and special interest groups of the IMIA, a total of 26 groups, were contacted via e-mail to provide a summary of the scientific-based efforts taken to combat COVID-19 pandemic and participate in the discussion toward the creation of this manuscript. A total of 13 groups participated in this manuscript. Results Various efforts were exerted by members of IMIA including (1) developing evidence-based guidelines for the design and deployment of digital health solutions during COVID-19; (2) surveying clinical informaticians internationally about key digital solutions deployed to combat COVID-19 and the challenges faced when implementing and using them; and (3) offering necessary resources for clinicians about the use of digital tools in clinical practice, education, and research during COVID-19. Discussion Rigor and evidence need to be taken into consideration when designing, implementing, and using digital tools to combat COVID-19 to avoid delays and unforeseen negative consequences. It is paramount to employ a multidisciplinary approach for the development and implementation of digital health tools that have been rapidly deployed in response to the pandemic bearing in mind human factors, ethics, data privacy, and the diversity of context at the local, national, and international levels. The training and capacity building of front-line workers is crucial and must be linked to a clear strategy for evaluation of ongoing experiences.
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| 9. |
- Guardado, Sharon, et al.
(författare)
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An Exploratory Study on the Utility of Patient-Generated Health Data as a Tool for Health Care Professionals in Multiple Sclerosis Care
- 2022
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Ingår i: Methods of Information in Medicine. - 0026-1270 .- 2511-705X.
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Tidskriftsartikel (refereegranskat)abstract
- Background Patient-generated health data (PGHD) are data collected through technologies such as mobile devices and health apps. The integration of PGHD into health care workflows can support the care of chronic conditions such as multiple sclerosis (MS). Patients are often willing to share data with health care professionals (HCPs) in their care team; however, the benefits of PGHD can be limited if HCPs do not find it useful, leading patients to discontinue data tracking and sharing eventually. Therefore, understanding the usefulness of mobile health (mHealth) solutions, which provide PGHD and serve as enablers of the HCPs' involvement in participatory care, could motivate them to continue using these technologies. Objective The objective of this study is to explore the perceived utility of different types of PGHD from mHealth solutions which could serve as tools for HCPs to support participatory care in MS. Method A mixed-methods approach was used, combining qualitative research and participatory design. This study includes three sequential phases: data collection, assessment of PGHD utility, and design of data visualizations. In the first phase, 16 HCPs were interviewed. The second and third phases were carried out through participatory workshops, where PGHD types were conceptualized in terms of utility. Results The study found that HCPs are optimistic about PGHD in MS care. The most useful types of PGHD for HCPs in MS care are patients' habits, lifestyles, and fatigue-inducing activities. Although these subjective data seem more useful for HCPs, it is more challenging to visualize them in a useful and actionable way. Conclusion HCPs are optimistic about mHealth and PGHD as tools to further understand their patients' needs and support care in MS. HCPs from different disciplines have different perceptions of what types of PGHD are useful; however, subjective types of PGHD seem potentially more useful for MS care.
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| 10. |
- Hallberg, Niklas, et al.
(författare)
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The medical software quality deployment method
- 1999
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Ingår i: Methods of Information in Medicine. - 0026-1270. ; 38:1, s. 66-73
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to develop a Quality Function Deployment (QFD) model for design of information systems in health-care environments. Consecutive blocked-subject case studies were conducted, based on action research methods. RESULTS: Starting with a QFD model for software development, a model for information system design, the Medical Software Quality Deployment (MSQD) model, was developed. The MSQD model was divided into the pre-study phase, in which the customer categories and their power to influence the design are determined; the data collection phase, in which the voice of customers (VoC) is identified by observations and interviews and quantified by Critical. Incident questionnaires; the need specification phase, where the VoC is specified into ranked customer needs; and the design phase where the customer needs are transformed stepwise to technical requirements and design attributes. QFD showed to be useful for integrating the values of different customer categories in software development for health-care settings. In the later design phases, other quality methods should be used for software implementation and testing.
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| 11. |
- Hartswood, Mark, et al.
(författare)
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Working out IT in Medical Practice : IT systems design and development as co-production
- 2003
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Ingår i: Methods of Information in Medicine. - : Schattauer GmbH. - 0026-1270. ; 42:4, s. 392-7
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Tidskriftsartikel (refereegranskat)abstract
- The paper explores possibilities for situating IT design and development work within the context of use so as to support the co-realisation of technology and `design in use'. The aim is to build a new understanding between IT professionals and users which is grounded upon what happens as the latter grapple with the problems of applying IT, appropriating its functionalities and affordances into their work practices and relations. Following a discussion of participatory design and ethnomethodology, a novel method called co-realisation, which aims to provide a synthesis of the preceding methods, is suggested as an alternative. Through a discussion of findings from a case study of IT systems design and development in healthcare it is shown how the co-realisation approach might provide work-affording systems and how user-design relations might be reformulated. It is suggested that work-affording systems can be developed through the deployment of an engaged facilitator who works with the users to unpack the work site-specific potentialities of technology. The case study shows how risk of non-adoption might be minimised through the development of partnerships, and how the presence of the facilitator in the workplace capitalises on the mundane work undertaken therein and how the facilitator might work with the users to develop artefacts that support this work as opposed to reconfiguring it. The case study illustrates co-realisation in action and how it might be seen to reconfigure relations between users and designers in a way that appears productive. Co-realisation can help address the widely observed problem of IT systems failures in healthcare
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| 12. |
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| 13. |
- Jacobsen, Marc, et al.
(författare)
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Deconfounding microarray analysis : independent measurements of cell type proportions used in a regression model to resolve tissue heterogeneity bias
- 2006
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Ingår i: Methods of Information in Medicine. - Stuttgart, Germany : Schattauer Gmbh. - 0026-1270 .- 2511-705X. ; 45:5, s. 557-63
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Microarray analysis requires standardized specimens and evaluation procedures to achieve acceptable results. A major limitation of this method is caused by heterogeneity in the cellular composition of tissue specimens, which frequently confounds data analysis. We introduce a linear model to deconfound gene expression data from tissue heterogeneity for genes exclusively expressed by a single cell type.Methods: Gene expression data are deconfounded from tissue heterogeneity effects by analyzing them using an appropriate linear regression model. In our illustrating data set tissue heterogeneity is being measured using flow cytometry. Gene expression data are determined in parallel by real time quantitative polymerase chain reaction (qPCR) and microarray analyses. Verification of deconfounding is enabled using protein quantification for the respective marker genes.Results: For our illustrating dataset, quantification of cell type proportions for peripheral blood mononuclear cells (PBMC) from tuberculosis patients and controls revealed differences in B cell and monocyte proportions between both study groups, and thus heterogeneity for the tissue under investigation. Gene expression analyses reflected these differences in celltype distribution. Fitting an appropriate linear model allowed us to deconfound measured transcriptome levels from tissue heterogeneity effects. In the case of monocytes, additional differential expression on the single cell level could be proposed. Protein quantification verified these deconfounded results.Conclusions: Deconfounding of transcriptome analyses for cellular heterogeneity greatly improves interpretability, and hence the validity of transcriptome profiling results.
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| 14. |
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| 15. |
- Juhola, Martti, et al.
(författare)
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Machine learning classification of psychiatric data associated with compensation claims for patient injuries
- 2023
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Ingår i: Methods of Information in Medicine. - : Georg Thieme Verlag KG. - 0026-1270. ; 62:05/06, s. 174-182
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Tidskriftsartikel (refereegranskat)abstract
- Background: Adverse events are common in health care. In psychiatric treatment, compensation claims for patient injuries appear to be less common than in other medical specialties. The most common types of patient injury claims in psychiatry include diagnostic flaws, unprevented suicide, or coercive treatment deemed as unnecessary or harmful.Objectives: The objective was to study whether it is possible to form different categories of patient injury types associated with the psychiatric evaluations of compensation claims and to base machine learning classification on these categories. Further, the binary classification of positive and negative decisions for compensation claims was the other objective.Methods: Finnish psychiatric specialist evaluations for the compensation claims of patient injuries were classified into six different categories called classes applying the machine learning methods of artificial intelligence. In addition, another classification of the same data into two classes was performed to test whether it was possible to classify data cases according to their known decisions, either accepted or declined compensation claim.Results: The former classification task produced relatively good classification results subject to separating between different classes. Instead, the latter was more complex. However, classification accuracies of both tasks could be improved by using the generation of artificial data cases in the preprocessing phase before classifications. This preprocessing improved the classification accuracy of six classes up to 88% when the method of random forests was used for classification and that of the binary classification to 89%. Conclusion The results show that the objectives defined were possible to solve reasonably.
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| 16. |
- Karlsson, Daniel, et al.
(författare)
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Extended telemedical consultation using Arden Syntax based decision support, hypertext and WWW technique
- 1997
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Ingår i: Methods of Information in Medicine. - 0026-1270. ; 36:2, s. 108-114
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Tidskriftsartikel (refereegranskat)abstract
- There is an obvious need for geographic distribution of expert knowledge among several health care units without increasing the cost of on-site expertise in locations where health care is provided. This paper describes the design of a knowledge-based decision-support system for extended consultation in clinical medicine. The system is based on Arden Syntax for Medical Logic Modules and hypertext using World Wide Web technology. It provides advice and explanations regarding the given advice. The explanations are presented in a hypertext format allowing the user to browse related information and to verify the relevance of the given advice. The system is intended to be used in a closed local network. With special precautions regarding issues of safety and patient security, the system can be used over wider areas such as in rural medicine. A prototype has been developed in the field of clinical microbiology and infectious diseases regarding infective endocarditis.
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| 17. |
- Klein, Gunnar O, 1953-
(författare)
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Standardization of health informatics - Results and challenges
- 2002
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Ingår i: Methods of Information in Medicine. - Stuttgart : Schattauer Gmbh. - 0026-1270 .- 2511-705X. ; 41:4, s. 261-270:1, s. 103-114
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: This review article aims to highlight the importance of standards for effective communication and provides an overview of international standardization activities.Methods: This article is based on the experience of the author of European standardization in CEN, which he leads, and the global work of ISO, where he is leading the security working group, and an overview of the work of DICOM, IEEE and HL7, partly using their web presentations.Results: Health communication is highly dependent of the general development of information technology with standards coming from ISQ/IEC ITC1, ITU and several other organizations e.g. IETE, the World Wide Web consortium and Open group. A number of standardization initiatives have been in progress for more than ten years with the aim to facilitate different aspects of the exchange of health information. Electronic record architecture, Message structures, Concept representation, Device communication including imaging and Security are the main areas.Conclusions: Important results have been achieved, and in some fields and parts of the worked, standards are widely used today. Unfortunately, we are still facing the fact that most healthcare information systems cannot exchange information with all systems for which this would be desired. Either the existing standards are not sufficiently implemented, or the required standards and necessary national implementation guidelines do not yet exist. This causes unacceptable risks to patients, inefficient use of healthcare resources, and sub optimal development of medical knowledge. Fortunately, the different bodies are now largely co-operating to achieve global consensus.
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| 18. |
- Koch, S, et al.
(författare)
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Back on Track
- 2017
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Ingår i: Methods of information in medicine. - : Georg Thieme Verlag KG. - 2511-705X .- 0026-1270. ; 56:4, s. 274-275
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Tidskriftsartikel (refereegranskat)
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| 19. |
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| 20. |
- Koch, S, et al.
(författare)
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Methods Refocused
- 2020
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Ingår i: Methods of information in medicine. - : Georg Thieme Verlag KG. - 2511-705X .- 0026-1270. ; 59:02/032-03, s. 57-58
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 21. |
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| 22. |
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| 23. |
- Mohd Sulaiman, Ismat, et al.
(författare)
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Mapping Acute Coronary Syndrome Registries to SNOMED CT. A Comparative Study between Malaysia and Sweden.
- 2017
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Ingår i: Methods of Information in Medicine. - : Schattauer Gmbh. - 0026-1270 .- 2511-705X. ; 56:4, s. 330-338
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Malaysia and Sweden have mapped their acute coronary syndrome registries using SNOMED CT. Since similar-purposed patient registries can be expected to collect similar data, these data should be mapped to the same SNOMED CT codes despite the different languages used. Previous studies have however shown variations in mapping between different mappers but the reasons behind these variations and the influence of different mapping approaches are still unknown.OBJECTIVES: To analyze similar-purposed registries and their registry-to-SNOMED CT maps, using two national acute coronary syndrome registries as examples, to understand the reasons for mapping similarities and differences as well as their implications.METHODS: The Malaysian National Cardiovascular Disease - Acute Coronary Syndrome (NCVD-ACS) registry was compared to the Swedish Register of Information and Knowledge about Swedish Heart Intensive Care Admissions (RIKS-HIA). The structures of NCVD-ACS and RIKS-HIA registry forms and their distributions of headings, variables and values were studied. Data items with equivalent meaning (EDIs) were paired and their mappings were categorized into match, mismatch, and non-comparable mappings. Reasons for match, mismatch and non-comparability of each paired EDI were seen as factors that contributed to the similarities and differences between the maps.RESULTS: The registries and their respective maps share a similar distribution pattern regarding the number of headings, variables and values. The registries shared 101 EDIs, whereof 42 % (42) were mapped to SNOMED CT. 45 % (19) of those SNOMED CT coded EDIs had matching codes. The matching EDIs occurred only in pre-coordinated SNOMED CT expressions. Mismatches occurred due to challenges arising from the mappers themselves, limitations in SNOMED CT, and complexity of the registries. Non-comparable mappings appeared due to the use of other coding systems, unmapped data items, as well as requests for new SNOMED CT concepts.CONCLUSIONS: To ensure reproducible and reusable maps, the following three actions are recommended: (i) develop a specific mapping guideline for patient registries; (ii) openly share maps; and (iii) establish collaboration between clinical research societies and the SNOMED CT community.
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| 24. |
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| 25. |
- Nilsson, Gunnar, et al.
(författare)
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Evaluation of three Swedish ICD-10 primary care versions : reliability and ease of use in diagnostic coding
- 2000
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Ingår i: Methods of Information in Medicine. - 0026-1270. ; 39:4-5, s. 325-331
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Tidskriftsartikel (refereegranskat)abstract
- If computer-stored information is to be useful for purposes other than patient care, reliability of the data is of utmost importance. In primary healthcare settings, however, it has been found to be poor. This paper presents a study on the influence of coding tools on reliability and user acceptance. Six general practitioners coded 152 medical problems each by means of three versions of ICD-10, one with a compositional structure. At code level the reliability was poor and was almost identical when the three versions were compared. At aggregated level the reliability was good and somewhat better in the compositional structure. Ideas for improved user acceptance arose, and the study explored the need for several different tools to retrieve diagnostic codes.
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| 26. |
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| 27. |
- Ockander, Marlene, 1971-, et al.
(författare)
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Patient-doctor Concordance in Elderly Women’s Self-reported Health and Medical Records
- 2002
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Ingår i: Methods of Information in Medicine. - 0026-1270. ; 41:2, s. 119-124
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To compare the chronic diseases mentioned by elderly women in an interview study with those documented in their respective medical records.METHODS: The prevalence of positive diagnoses, overall agreement, and the kappa-coefficient were calculated for each group of diagnoses.RESULTS: The lowest overall agreement was observed for psychiatric diseases, followed by diseases of the gastrointestinal system. Poor chance-adjusted agreement was found concerning diseases of the gastrointestinal system and diseases of the skin.CONCLUSIONS: The results suggest that a main reason for discordance was that the elderly women feared "losing face" by reporting some diseases.
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| 28. |
- Oh, J. H., et al.
(författare)
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A Factor Analysis Approach for Clustering Patient Reported Outcomes
- 2016
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Ingår i: Methods of Information in Medicine. - : Georg Thieme Verlag KG. - 0026-1270 .- 2511-705X. ; 55:5, s. 431-439
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Tidskriftsartikel (refereegranskat)abstract
- Background: In the field of radiation oncology, the use of extensive patient reported outcomes is increasingly common to measure adverse side effects after radiotherapy in cancer patients. Factor analysis has the potential to identify an optimal number of latent factors (i.e., symptom groups). However, the ultimate goal of treatment response modeling is to understand the relationship between treatment variables such as radiation dose and symptom groups resulting from FA. Hence, it is crucial to identify clinically more relevant symptom groups and improved response variables from those symptom groups for a quantitative analysis. Objectives: The goal of this study is to design a computational method for finding clinically relevant symptom groups from PROs and to test associations between symptom groups and radiation dose. Methods: We propose a novel approach where exploratory factor analysis is followed by confirmatory factor analysis to determine the relevant number of symptom groups. We also propose to use a combination of symptoms in a symptom group identified as a new response variable in linear regression analysis to investigate the relationship between the symptom group and dose-volume variables. Results: We analyzed patient-reported gastrointestinal symptom profiles from 3 datasets in prostate cancer patients treated with radiotherapy. The final structural model of each dataset was validated using the other two datasets and compared to four other existing FA methods. Our systematic EFA-CFA approach provided clinically more relevant solutions than other methods, resulting in new clinically relevant outcome variables that enabled a quantitative analysis. As a result, statistically significant correlations were found between some dose volume variables to relevant anatomic structures and symptom groups identified by FA. Conclusions: Our proposed method can aid in the process of understanding PROs and provide a basis for improving our understanding of radiation-induced side effects.
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| 29. |
- Pueyo, E, et al.
(författare)
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Time course of ECG depolarization and repolarization changes during ischemia in PTCA recordings
- 2004
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Ingår i: Methods of Information in Medicine. - 0026-1270. ; 43:1, s. 43-46
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: In this work we studied the temporal evolution of changes in the electrocardiogram (ECG) as a consequence of the induced ischemia during prolonged coronary angioplasty, comparing the time course of indexes reflecting depolarization and those reflecting repolarization. Methods: We considered both local (measured at specific points of the ECG) and global (obtained from the Karhunen-Loeve transform) indexes. In particular, the evolution of Q, R and S wave amplitudes during ischemia was analyzed with respect to classical indexes such as ST level. As a measurement of sensitivity we used an Ischemic Changes Sensor (ICS), which reflects the capacity of an index to detect changes in the ECG. Results: The results showed that, in leads with low-amplitude ST-T complexes, the S wave amplitude was more sensitive in detecting ischemia than was the commonly used index ST60. It was found that in such leads the S wave amplitude initially exhibited a delayed response to ischemia when compared to ST60, but its performance was better from the second minute of occlusion. The global indexes describing the ST-T complex were, in terms of the ICS, superior to the S wave amplitude for ischemia detection. Conclusions: Ischemic ECG changes occur both at repolarization and depolarization, with alterations in the depolarization period appearing later in time. Local indexes are less sensitive to ischemia than global ones.
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| 30. |
- Repsilber, Dirk, 1971-, et al.
(författare)
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Sample selection for microarray gene expression studies
- 2005
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Ingår i: Methods of Information in Medicine. - Stuttgart, Germany : Schattauer Gmbh. - 0026-1270 .- 2511-705X. ; 44:3, s. 461-7
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The choice of biomedical samples for microarray gene expression studies is decisive for both validity and interpretability of results. We present a consistent, comprehensive framework to deal with the typical selection problems in microarray studies.Methods: Microarray studies are designed either as case-control studies or as comparisons of parallel groups from cohort studies, since high levels of random variation in the experimental approach thwart absolute measurements of gene expression levels. Validity and results of gene expression studies heavily rely on the appropriate choice of these study groups. Therefore, the so-called principles of comparability, which are well known from both clinical and epidemiological studies, need to be applied to microarray experiments.Results: The principles of comparability are the study-base principle, the principle of deconfounding and the principle of comparable accuracy in measurements. We explain each of these principles, show how they apply to microarray experiments, and illustrate them with examples. The examples are chosen as to represent typical stumbling blocks of microarray experimental design, and to exemplify the benefits of implementing the principles of comparability in the setting of microarray experiments.Conclusions: Microarray studies are closely related to classical study designs and therefore have to obey the same principles of comparability as these. Their validity should not be compromised by selection, confounding or information bias. The so-called study-base principle, calling for comparability and thorough definition of the compared cell populations, is the key principle for the choice of biomedical samples and controls in microarray studies.
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| 31. |
- Repsilber, Dirk, 1971-, et al.
(författare)
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Tutorial on microarray gene expression experiments : An introduction
- 2005
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Ingår i: Methods of Information in Medicine. - Stuttgart, Germany : Schattauer Gmbh. - 0026-1270 .- 2511-705X. ; 44:3, s. 392-9
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: With the collection of articles presented in this special issue, we aim at educating interested statisticians and biometricians on the one hand as well as biologists and medical researchers on the other with respect to basic necessities in planning, conducting and analyzing microarray gene expression experiments. The reader should get comprehensive directions to understand both the overall structure of this approach as well as the decisive details, which enable--or thwart--a meaningful data analysis.Methods: For a one-day workshop with tutorial character we brought together experts in design, conduct and analysis of microarray gene expression experiments who prepared a series of comprehensive lessons. These contributions were then reworked into a series of introductory articles and bundled in form and content as a Special Topic.Results: It was possible to present a tutorial overview of the field. The interested reader was able to learn the basic necessities and was referred to further references for details on the possible alternatives. A recipe style all-embracing plan, covering all eventualities and possibilities was not only beyond the scope of an introductory tutorial-like presentation, but was also not yet agreed upon by the scientific society.Conclusions: It proved feasible to find a framework for integrating the interdisciplinary approaches to the challenging field of gene expression analysis with microarrays, hopefully contributing to a rapid and comprehensive introduction for novices.
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| 32. |
- Repsilber, Dirk, 1971-, et al.
(författare)
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Two-color microarray experiments. Technology and sources of variance
- 2005
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Ingår i: Methods of Information in Medicine. - Stuttgart, Germany : Schattauer Gmbh. - 0026-1270 .- 2511-705X. ; 44:3, s. 400-4
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Microarray gene expression experiments have a complex technical background. Knowledge about certain technical details is inevitable to judge alternatives for both experimental design and analysis. Here, we introduce the necessary details for the so-called two-color microarray experiments and review major sources of technical variance.Methods: We follow the sequence of experimental steps during a typical two-color microarray gene expression experiment, stressing decisive points in the choice of technique, experimental handling and biophysical basics. We point out where technical variation is to be expected.Results: Tissue storage, RNA extraction techniques, as well as the microarray hybridization represent major components of technical variance to be considered. Depending on the possibilities for access to the biomedical material under investigation, choice of amplification and labeling techniques can also be decisive to avoid additional technical variance. The two-color microarray experimental approach seeks to avoid a group of probe-level technical biases making use of the advantages of an incomplete block-design.Conclusions: It is worth to know the major sources of technical variance during the typical experimental sequence, both for choice of experimental design and techniques of molecular biology, as well as for the understanding of quality control and normalization approaches. Here, early investments pay at the level of reduced technical variance, allowing for enhanced detection levels for the effects under investigation.
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| 33. |
- Rossander, Anna, 1980, et al.
(författare)
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A State-of-the Art Review of SNOMED CT Terminology Binding and Recommendations for Practice and Research
- 2021
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Ingår i: Methods of Information in Medicine. - : Georg Thieme Verlag KG. - 0026-1270 .- 2511-705X. ; 60
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Forskningsöversikt (refereegranskat)abstract
- Background: Unambiguous sharing of data requires information models and terminology in combination, but there is a lack of knowledge as to how they should be combined, leading to impaired interoperability. Objectives: To facilitate creation of guidelines for SNOMED CT terminology binding we have performed a literature review to find existing recommendations and expose knowledge gaps. The primary audience is practitioners and researchers working with terminology binding. Methods: PubMed, Scopus, and Web of Science were searched for papers containing “terminology binding,” “subset,” “map,” “information model” or “implement” and the term “SNOMED.” Results: The search yielded 616 unique papers published from 2004 to 2020, from which 55 papers were selected and analyzed inductively. Topics described in the papers include problems related to input material, SNOMED CT, information models, and lack of appropriate tools as well as recommendations regarding competence. Conclusion: Recommendations are given for practitioners and researchers. Many of the stated problems can be solved by better co-operation between domain experts and informaticians and better knowledge of SNOMED CT. Settings where these competences either work together or where staff with knowledge of both act as brokers are well equipped for terminology binding. Tooling is not thoroughly researched andmight be a possible way to facilitate terminology binding.
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| 34. |
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| 35. |
- Vimarlund, Vivian, 1951-, et al.
(författare)
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Design participation as an insurance : Risk-management and end-user participation in the development of information systems in healthcare organizations
- 2002
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Ingår i: Methods of Information in Medicine. - 0026-1270. ; 41:1, s. 76-80
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this paper is to build a theoretical framework for analysis of when decision-makers should use end-user participation as a form of insurance for unforeseen consequences of implementing information systems in healthcare organizations. Method: Data were collected in a case study of an information system development project in a small clinical setting. During the initial phase, the future end-users of the system were allowed to actively influence the system design and test every new tool that was considered for implementation. Results: The results of the case study suggest that when time and effort are invested in allowing healthcare staff to participate in information system development processes, the benefits can well exceed the costs throughout the life cycle of the project. Risk-averse decision-makers fearing negative secondary consequences of a HIS, with regard to clinical work flow, will always adopt measures to prevent future failures, if they can find a possibility of shifting these risks. Therefore, they calculate the present discounted value of the effects accrued over time to the unit and predict the amount of resources they are willing to pay to acquire an insurance (such as design participation) that will protect the organization from future losses. Conclusions: End-user participation in the design process can be the key positive influence on the quality of the service and, thereby, organizational effectiveness. Investments in broad design participation can, consequently, be a productive activity that transforms potential current income into future benefits.
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| 36. |
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| 37. |
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| 38. |
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| 39. |
- Ölvingson, Christina, et al.
(författare)
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Requirements Engineering for inter-organizational health information systems with functions for spatial analyses : modeling a WHO safe community applying Use Case Maps
- 2002
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Ingår i: Methods of Information in Medicine. - 0026-1270. ; 41:4, s. 299-304
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To evaluate Use Case Maps (UCMs) as a technique for Requirements Engineering (RE) in the development of information systems with functions for spatial analyses in inter-organizational public health settings.Methods: In this study, Participatory Action Research (PAR) is used to explore the UCM notation for requirements elicitation and to gather the opinions of the users. The Delphi technique is used to reach consensus in the construction of UCMs.Results: The results show that UCMs can provide a visualization of the system's functionality and in combination with PAR provide a sound basis for gathering requirements in inter-organizational settings. UCMs were found to represent a suitable level for describing the organization and the dynamic flux of information including spatial resolution to all stakeholders. Moreover, by using PAR, the voices of the users and their tacit knowledge is intercepted. Further, UCMs are found useful in generating intuitive requirements by the creation of use cases.Conclusions: With UCMs and PAR it is possible to study the effects of design changes in the general information display and the spatial resolution in the same context. Both requirements on the information system in general and the functions for spatial analyses are possible to elicit when identifying the different responsibilities and the demands on spatial resolution associated to the actions of each administrative unit. However, the development process of UCM is not well documented and needs further investigation and formulation of guidelines.
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