Hasta yönelimli bir karar destek çerçevesi ve prostat karsinomunda biyopsi kararına uygulanması.

Serum PSA (Prostate Specific Antigen) level is used for prediction of prostatic carcinoma, but it suffers from weak sensitivity and specificity. We applied logistic regression, artificial neural networks, decision tree, and genetic algorithm to prostate cancer prediction problem to design a model for Turkish population. A hybrid model of logistic regression and decision tree has been designed. The model could prevent 33 biopsies (4.4% of our patients who have PSA level between 0 and 10) from our data set without a loss from sensitivity. The prepared online decision support tool and a questionnaire were published on a website. Fifty urologists have completed the questionnaire. Cronbach’s alpha was 0.770. On a five graded Likert scale, the mean score of “attitude to computer use in healthcare” (ACH) was 4.2. The mean of eight responses related to the online tool (Attitude to Decision Support Tool; ADST), was 3.7. ADST was correlated with ACH (r=0.351, p=0.013). Physicians who have positive attitude to computer use in healthcare tend to use the tool (r=0.459, p=0.001). The first factor influencing the opinions of the urologists was the attitude of the user to computer use in healthcare, the other factor was the attitude of the user to the decision support tool itself. To increase the acceptance, education and training of physicians in the use of information technologies in healthcare, informing users about the logic of the decision support tool, and redesigning the system according to user feedback may be helpful.Ph.D. - Doctoral Progra

Research Subjects and Research Trends in Medical Informatics

OBJECTIVES: To identify major research subjects and trends in medical informatics research based on the current set of core medical informatics journals. METHODS: Analyzing journals in the Web of Science (WoS) medical informatics category together with related categories from the years 2013 to 2017 by using a smart local moving algorithm as a clustering method for identifying the core set of journals. Text mining analysis with binary counting of abstracts from these journals published in the years 2006 to 2017 for identifying major research subjects. Building clusters based on these terms for the complete time period as well as for the periods 2006-2008, 2009-2011, 2012-2014, and 2015-2017 for identifying trends. RESULTS: The identified cluster includes 17 core medical informatics journals. By text mining of these journals, 224,992 different terms in 14,414 articles were identified covering 550 specific key terms. Based on these key terms five clusters were identified: "Biomedical Data Analysis," "Clinical Informatics," "EHR and Knowledge Representation," "Mobile Health," and "Organizational Aspects of Health Information Systems." No shifts in the clusters were observed between the first two 3-year periods. In the third period, some terms like "mobile phone," "mobile apps," and "message" appear. Also, in the third period, a "Clinical Informatics" cluster appears and persists in the fourth period. In the fourth period, a rearrangement of clusters was observed. CONCLUSIONS: Beside classical subjects of medical informatics on organizing, representing, and analyzing data, we observed new developments in the context of mobile health and clinical informatics. These subjects tended to grow over the past years, and we can expect this trend to continue

Comparison of methods for prediction of prostate cancer in Turkish men with PSA levels of 0-10 ng/mL

Purpose: Several concepts to improve the diagnostic accuracy of prostate specific antigen (PSA) for prediction of prostate cancer have been studied. The aim of this study was to examine and compare the methods used for improving the diagnostic accuracy of PSA in a country with low incidence of prostate cance

A new approach in the evaluation of hospital information systems

Hospital information system (HIS) evaluation frameworks have largely been discussed in the literature. However, existing frameworks lack one important aspect: to what extent user expectations of HISs are met. In this study, user expectation data are collected by means of the 'expectation questionnaire'. The internal consistencies of the answers to the questionnaire are measured by Cronbach's alpha coefficient. Fuzzy logic methodologies are used to evaluate the expectation variables in the proposed evaluation framework. The evaluation variables are not represented in the results equally; they are reflected by the weights assigned by the users. Our proposed framework provides the overall degree of to what extent the user expectations are met. It also gives the opportunity to analyze to what extent each expectation is met and the degree of to what extent different user groups' expectations are met. The proposed framework is not a rival of but is rather an alternative or complementary to the existing frameworks. It is a different approach and has a different computation methodology, supported by fuzzy logic. The acceptable meeting ratio depends on the evaluator; we do not propose a threshold

The Knowledge Level and Opinions of Physicians about the Medical and Legal Procedures Related to Physical Child Abuse

Background: In order to diagnose child abuse, physicians need to consider the possibility of abuse in every child they encounter, have sufficient information about the topic and manage the cases according to current law. Aims: To determine the knowledge level of physicians on child abuse and to learn their opinions about the procedures when they suspect child abuse. Study Design: A questionnaire (cross-sectional) study. Methods: A detailed questionnaire was applied to 390 physicians of whom 233 were general practitioners. The first part of the questionnaire included demographic variables (age, gender, occupational experience) and the frequency of child physical abuse cases encountered, since that is the most easily diagnosed and proven form of abuse. The second part consisted of 32 questions about diagnosis of physical child abuse and procedures during the follow-up of the cases. Statistical analyses were performed using SPSS version 18.0. Results: Of the participating physicians, 47.4% (n=185) were female and only 13.1% of the physicians had some kind of postgraduate training on child abuse. The correct response rate of specialists compared to general practitioners was significantly higher. A total of 263 (72.3%) physicians thought that there was a specific law on physical child abuse in the Turkish Republic. More than two-thirds of physicians thought that reporting should only be addressed to Social Services and physicians should not be obliged to report to law enforcement. Conclusion: The results of the present study adds to the already known necessity for better training of physicians about physical child abuse and the need to refresh their knowledge through postgraduate courses. According to current regulations, it is obligatory to report abuse cases to the public prosecutor and/or police, therefore physicians also need training in respect of the legal status and medico-legal approach to these case