Clinical protocols enabling evidence based medicine practice in healthcare software solutions

Estágio realizado na ALERT Life Sciences Computing, S. A.Tese de mestrado integrado. Engenharia Informática e Computação. Faculdade de Engenharia. Universidade do Porto. 200

Encoding models for scholarly literature

We examine the issue of digital formats for document encoding, archiving and publishing, through the specific example of "born-digital" scholarly journal articles. We will begin by looking at the traditional workflow of journal editing and publication, and how these practices have made the transition into the online domain. We will examine the range of different file formats in which electronic articles are currently stored and published. We will argue strongly that, despite the prevalence of binary and proprietary formats such as PDF and MS Word, XML is a far superior encoding choice for journal articles. Next, we look at the range of XML document structures (DTDs, Schemas) which are in common use for encoding journal articles, and consider some of their strengths and weaknesses. We will suggest that, despite the existence of specialized schemas intended specifically for journal articles (such as NLM), and more broadly-used publication-oriented schemas such as DocBook, there are strong arguments in favour of developing a subset or customization of the Text Encoding Initiative (TEI) schema for the purpose of journal-article encoding; TEI is already in use in a number of journal publication projects, and the scale and precision of the TEI tagset makes it particularly appropriate for encoding scholarly articles. We will outline the document structure of a TEI-encoded journal article, and look in detail at suggested markup patterns for specific features of journal articles

Design and Development of Virtual Patients for Healthcare Education: State of the Art and Research

The digital transformation of healthcare and the COVID-19 pandemic have accelerated research and deployment of virtual patients (VP), that is, interactive computer simulations used in healthcare education to train students on clinical processes. To help researchers and practitioners understand the state of the art in VP development, we conducted a systematic literature review of 48 papers. Our analysis focused on educational level, medical specialty, competencies, technologies, technical format, and operating systems and tools. We found that VPs are primarily used in the medical field and student education as interactive patient scenarios based on multimedia system technology. VP authoring systems were identified as the primary tool for developing primary clinical reasoning skills. Based on our findings, we suggest implications for medical education research and practice

Confronting the Ghost: Legal Strategies to Oust Medical Ghostwriters

Articles published in medical journals contribute significantly to public health by disseminating medical information to physicians, thereby influencing prescribing practices. However, the information guiding treatment decisions becomes distorted by selective publishing and medical ghostwriting, which negatively affects overall patient care. Although there is general consensus in the medical community that these practices of publication bias represent a moral failing, the issue is rarely framed as a wrong that necessitates legal consequences. This Note takes the stance that medical ghostwriting constitutes an act prohibited under the Racketeer Influenced and Corrupt Organizations Act (RICO) and argues that physicians fraudulently named as authors should be held civilly liable under RICO. This Note explores civil RICO, its origin, its legislative and judicial history, and the evolution of RICO to areas beyond traditional organized crime. By applying the elements of civil RICO to medical ghostwriting, this Note argues that physicians named as authors who knowingly fail to fulfill journal authorship criteria should be held accountable for their role in disseminating misleading medical information. This Note argues that, at the very least, current regulations governing the medical publication framework should be better enforced and revised to mandate authorship disclosure

Integration of tools for binding archetypes to SNOMED CT

Background The Archetype formalism and the associated Archetype Definition Language have been proposed as an ISO standard for specifying models of components of electronic healthcare records as a means of achieving interoperability between clinical systems. This paper presents an archetype editor with support for manual or semi-automatic creation of bindings between archetypes and terminology systems. Methods Lexical and semantic methods are applied in order to obtain automatic mapping suggestions. Information visualisation methods are also used to assist the user in exploration and selection of mappings. Results An integrated tool for archetype authoring, semi-automatic SNOMED CT terminology binding assistance and terminology visualization was created and released as open source. Conclusion Finding the right terms to bind is a difficult task but the effort to achieve terminology bindings may be reduced with the help of the described approach. The methods and tools presented are general, but here only bindings between SNOMED CT and archetypes based on the openEHR reference model are presented in detail. Background The Archetype formalism and the associated Archetype Definition Language have been proposed as an ISO standard for specifying models of components of electronic healthcare records as a means of achieving interoperability between clinical systems. This paper presents an archetype editor with support for manual or semi-automatic creation of bindings between archetypes and terminology systems. Methods Lexical and semantic methods are applied in order to obtain automatic mapping suggestions. Information visualisation methods are also used to assist the user in exploration and selection of mappings. Results An integrated tool for archetype authoring, semi-automatic SNOMED CT terminology binding assistance and terminology visualization was created and released as open source. Conclusion Finding the right terms to bind is a difficult task but the effort to achieve terminology bindings may be reduced with the help of the described approach. The methods and tools presented are general, but here only bindings between SNOMED CT and archetypes based on the openEHR reference model are presented in detail.Original Publication: Erik Sundvall, Rahil Qamar, Mikael Nyström, Mattias Forss, Håkan Petersson, Hans Åhlfeldt and Alan Rector, Integration of Tools for Binding Archetypes to SNOMED CT, 2008, BMC Medical Informatics and Decision Making, (8), S7. http://dx.doi.org/10.1186/1472-6947-8-S1-S7 Licensee: BioMed Central http://www.biomedcentral.com/</p