Medical devices nomenclature systems: a scoping review

Inventory is a fundamental process throughout the life cycle of medical devices. The maintenance program for each piece of equipment must comply with current regulations that are constantly evolving. The need to set up an evidence based management of the inventory of thousands of medical devices hosted in the Careggi University Hospital (AOUC), in Florence (Italy), has suggested to conceive a method to group medical devices in sub-classes, in order to monitor their performances and maintenance. The starting point to reach this goal is to establish a suitable nomenclature, a complex system of rules, codes, and definitions employed by healthcare systems and organizations to identify sets of medical devices. This paper describes the literature search performed on both Ovid and Scopus databases, that made it possible to identify several classifications and nomenclatures for medical devices. On the basis of this search, only a few works fulfil the requirement of classifying medical devices for management purposes (e.g., inventories, database, and supply chains). The analysis has shown that it is possible to reduce the number of classes into macro groups when applying the Italian National Classification of Medical Devices (CND). Although the CND nomenclature shows inconsistencies for complex groups it is an effective and successful choice, in terms of efficiency and optimization, also considering that it is the basis for the European Medical Device Nomenclature (EMDN)

Enriching information extraction pipelines in clinical decision support systems

Programa Oficial de Doutoramento en Tecnoloxías da Información e as Comunicacións. 5032V01[Resumo] Os estudos sanitarios de múltiples centros son importantes para aumentar a repercusión dos resultados da investigación médica debido ao número de suxeitos que poden participar neles. Para simplificar a execución destes estudos, o proceso de intercambio de datos debería ser sinxelo, por exemplo, mediante o uso de bases de datos interoperables. Con todo, a consecución desta interoperabilidade segue sendo un tema de investigación en curso, sobre todo debido aos problemas de gobernanza e privacidade dos datos. Na primeira fase deste traballo, propoñemos varias metodoloxías para optimizar os procesos de estandarización das bases de datos sanitarias. Este traballo centrouse na estandarización de fontes de datos heteroxéneas nun esquema de datos estándar, concretamente o OMOP CDM, que foi desenvolvido e promovido pola comunidade OHDSI. Validamos a nosa proposta utilizando conxuntos de datos de pacientes con enfermidade de Alzheimer procedentes de distintas institucións. Na seguinte etapa, co obxectivo de enriquecer a información almacenada nas bases de datos de OMOP CDM, investigamos solucións para extraer conceptos clínicos de narrativas non estruturadas, utilizando técnicas de recuperación de información e de procesamento da linguaxe natural. A validación realizouse a través de conxuntos de datos proporcionados en desafíos científicos, concretamente no National NLP Clinical Challenges(n2c2). Na etapa final, propuxémonos simplificar a execución de protocolos de estudos provenientes de múltiples centros, propoñendo solucións novas para perfilar, publicar e facilitar o descubrimento de bases de datos. Algunhas das solucións desenvolvidas están a utilizarse actualmente en tres proxectos europeos destinados a crear redes federadas de bases de datos de saúde en toda Europa.[Resumen] Los estudios sanitarios de múltiples centros son importantes para aumentar la repercusión de los resultados de la investigación médica debido al número de sujetos que pueden participar en ellos. Para simplificar la ejecución de estos estudios, el proceso de intercambio de datos debería ser sencillo, por ejemplo, mediante el uso de bases de datos interoperables. Sin embargo, la consecución de esta interoperabilidad sigue siendo un tema de investigación en curso, sobre todo debido a los problemas de gobernanza y privacidad de los datos. En la primera fase de este trabajo, proponemos varias metodologías para optimizar los procesos de estandarización de las bases de datos sanitarias. Este trabajo se centró en la estandarización de fuentes de datos heterogéneas en un esquema de datos estándar, concretamente el OMOP CDM, que ha sido desarrollado y promovido por la comunidad OHDSI. Validamos nuestra propuesta utilizando conjuntos de datos de pacientes con enfermedad de Alzheimer procedentes de distintas instituciones. En la siguiente etapa, con el objetivo de enriquecer la información almacenada en las bases de datos de OMOP CDM, hemos investigado soluciones para extraer conceptos clínicos de narrativas no estructuradas, utilizando técnicas de recuperación de información y de procesamiento del lenguaje natural. La validación se realizó a través de conjuntos de datos proporcionados en desafíos científicos, concretamente en el National NLP Clinical Challenges (n2c2). En la etapa final, nos propusimos simplificar la ejecución de protocolos de estudios provenientes de múltiples centros, proponiendo soluciones novedosas para perfilar, publicar y facilitar el descubrimiento de bases de datos. Algunas de las soluciones desarrolladas se están utilizando actualmente en tres proyectos europeos destinados a crear redes federadas de bases de datos de salud en toda Europa.[Abstract] Multicentre health studies are important to increase the impact of medical research findings due to the number of subjects that they are able to engage. To simplify the execution of these studies, the data-sharing process should be effortless, for instance, through the use of interoperable databases. However, achieving this interoperability is still an ongoing research topic, namely due to data governance and privacy issues. In the first stage of this work, we propose several methodologies to optimise the harmonisation pipelines of health databases. This work was focused on harmonising heterogeneous data sources into a standard data schema, namely the OMOP CDM which has been developed and promoted by the OHDSI community. We validated our proposal using data sets of Alzheimer’s disease patients from distinct institutions. In the following stage, aiming to enrich the information stored in OMOP CDM databases, we have investigated solutions to extract clinical concepts from unstructured narratives, using information retrieval and natural language processing techniques. The validation was performed through datasets provided in scientific challenges, namely in the National NLP Clinical Challenges (n2c2). In the final stage, we aimed to simplify the protocol execution of multicentre studies, by proposing novel solutions for profiling, publishing and facilitating the discovery of databases. Some of the developed solutions are currently being used in three European projects aiming to create federated networks of health databases across Europe

Quantitative imaging in radiation oncology

Artificially intelligent eyes, built on machine and deep learning technologies, can empower our capability of analysing patients’ images. By revealing information invisible at our eyes, we can build decision aids that help our clinicians to provide more effective treatment, while reducing side effects. The power of these decision aids is to be based on patient tumour biologically unique properties, referred to as biomarkers. To fully translate this technology into the clinic we need to overcome barriers related to the reliability of image-derived biomarkers, trustiness in AI algorithms and privacy-related issues that hamper the validation of the biomarkers. This thesis developed methodologies to solve the presented issues, defining a road map for the responsible usage of quantitative imaging into the clinic as decision support system for better patient care

Usability analysis of contending electronic health record systems

In this paper, we report measured usability of two leading EHR systems during procurement. A total of 18 users participated in paired-usability testing of three scenarios: ordering and managing medications by an outpatient physician, medicine administration by an inpatient nurse and scheduling of appointments by nursing staff. Data for audio, screen capture, satisfaction rating, task success and errors made was collected during testing. We found a clear difference between the systems for percentage of successfully completed tasks, two different satisfaction measures and perceived learnability when looking at the results over all scenarios. We conclude that usability should be evaluated during procurement and the difference in usability between systems could be revealed even with fewer measures than were used in our study. © 2019 American Psychological Association Inc. All rights reserved.Peer reviewe