Measuring diversity in medical reports based on categorized attributes and international classification systems

<p>Abstract</p> <p>Background</p> <p>Narrative medical reports do not use standardized terminology and often bring insufficient information for statistical processing and medical decision making. Objectives of the paper are to propose a method for measuring diversity in medical reports written in any language, to compare diversities in narrative and structured medical reports and to map attributes and terms to selected classification systems.</p> <p>Methods</p> <p>A new method based on a general concept of f-diversity is proposed for measuring diversity of medical reports in any language. The method is based on categorized attributes recorded in narrative or structured medical reports and on international classification systems. Values of categories are expressed by terms. Using SNOMED CT and ICD 10 we are mapping attributes and terms to predefined codes. We use f-diversities of Gini-Simpson and Number of Categories types to compare diversities of narrative and structured medical reports. The comparison is based on attributes selected from the Minimal Data Model for Cardiology (MDMC).</p> <p>Results</p> <p>We compared diversities of 110 Czech narrative medical reports and 1119 Czech structured medical reports. Selected categorized attributes of MDMC had mostly different numbers of categories and used different terms in narrative and structured reports. We found more than 60% of MDMC attributes in SNOMED CT. We showed that attributes in narrative medical reports had greater diversity than the same attributes in structured medical reports. Further, we replaced each value of category (term) used for attributes in narrative medical reports by the closest term and the category used in MDMC for structured medical reports. We found that relative Gini-Simpson diversities in structured medical reports were significantly smaller than those in narrative medical reports except the "Allergy" attribute.</p> <p>Conclusions</p> <p>Terminology in narrative medical reports is not standardized. Therefore it is nearly impossible to map values of attributes (terms) to codes of known classification systems. A high diversity in narrative medical reports terminology leads to more difficult computer processing than in structured medical reports and some information may be lost during this process. Setting a standardized terminology would help healthcare providers to have complete and easily accessible information about patients that would result in better healthcare.</p

Data Structuring and Modeling of Dental Documentation in a Form of Interactive Dental Cross

Many different investments have gone into hospital information systems worldwide. When those systems are evaluated, most of them do not meet clinicians' needs. To address the shortcomings EuroMISE Centre has developed an electronic health record (EHR) application MUDRLite, which can be customized to needs of a particular health care provider. To address the shortcomings especially in dental medicine we have brought together a unique cross-disciplinary collaborative group of computer scientists, statisticians, software developers, and clinicians, from the Department of Medical Informatics, Institute of Computer Science, Academy of Sciences of the Czech Republic and the Department of Prosthodontics of the Charles University in Prague, 1st Medical Faculty, to collaborate on research and development with the prevailing goal of providing consistency in electronic recording, archiving, analyzing and disseminating of dental medicine data.A highly-advanced MUDRLite component implementing the interactive dental cross represents one of the results of the joined effort. The data model of this component originates in a technology called "Dental Medicine Data Structuring Technology Using a Dental Cross". This technology was enrolled as a patent application form under the No. PV 2005-229.Using the dental cross component a dentist can choose among about 60 different actions, treatment procedures or dental parameters that are displayed lucidly on the screen. The components support typical clinical workflows including treatment of primary and secondary caries, fillings, pulp pathology etc. It combines a treatment plan with an interactive calendar that enables to schedule patients' visits and treatments.The interactive dental cross analysis was prepared in a form of a case report. Information record in a graphic structure accelerates dentist's decision-making and it enables a more complex view while suggesting a treatment plan

Synergy between medical informatics and bioinformatics: facilitating genomic medicine for future health care

Medical Informatics (MI) and Bioinformatics (BI) are two interdisciplinary areas located at the intersection between computer science and medicine and biology, respectively. Historically, they have been separated and only occasionally have researchers of both disciplines collaborated. The completion of the Human Genome Project has brought about in this post genomic era the need for a synergy of these two disciplines to further advance in the study of diseases by correlating essential genotypic information with expressed phenotypic information. Biomedical Informatics (BMI) is the emerging technology that aims to put these two worlds together in the new rising genomic medicine. In this regard, institutions such as the European Commission have recently launched several initiatives to support a new combined research agenda, based on the potential for synergism of both disciplines. In this paper we review the results the BIOINFOMED study one of these projects funded by the E

Comparative histochemical and biochemical studies on acid β-galactosidase activity in the experimentally injured rabbit cornea and tear fluid using the sensitive substrate β-galactoside-4-trifluoromethylumbelliferyl (HFC)

Comparative histochemical and biochemical studies on acid β-galactosidase activity in the rabbit eye after various experimental injuries were performed using the same sensitive fluorogenic substrate β-galactoside-4- trifluoromethylumbelliferyl (HFC). The aim of the study was to examine whether the severity of corneal damage corresponds with the level of the enzyme activity in the tear fluid. As until recently the substrate β-galactoside-4- HFC had not been used for the histochemical detection of acid β-galactosidase in the cornea, results obtained with this substrate in a fluorescent method were compared in parallel cryostat sections with results obtained using the substrate 5-bromo-4-chloro-3-indoxyl β-galactoside in the indigogenic method (previously shown to be very sensitive for the detection of acid β- galactosidase activity in the cornea). Both methods revealed similar localization and changes in enzyme activity; using β-galactoside-4-HFC an acceptable cellular localization was achieved. For the measurement of acid β-galactosidase activity in the tear fluid a semiquantitative biochemical method was elaborated using filter paper punches with the substrate (β-galactoside- 4-HFC) soaked with tears and incubated at 37 "C. The time of the first appearance of a greenishyellow fluorescence (enzyme positivity) was recorded by UV lamp and compared with the appearance of fluorescence in calibrated punches containing known acid β-galactosidase activities. The results show that β-galactoside- 4-HFC is useful for the biochemical assessment of acid β-galactosidase activity in the tear fluid. Comparing histochemical and biochemical results, it can be concluded that increased enzymatic activity in tears parallels the severity of corneal damage. Further studies are necessary to evaluate whether the detection of acid β-galactosidase activity in tears might be useful for diagnostic purposes in humans

Dipeptidyl peptidase IV (DPPIV) activity in the tear fluid as an indicator of the severity of corneal injury: a histochemical and biochemical study

Comparative histochemical and biochemical studies on the catalytically active protease Dipeptidyl peptidase IV (DPPIV), have been performed in the rabbit cornea and the tear fluid using a sensitive fluorogenic substrate, Gly-Pro-7-amino-4- Trifluoromethyl Coumarine (AFC). In both normal and experimentally injured corneas, DPPIV activity was detected histochemically and in the tear fluid biochemically. In contrast to the normal cornea where DPPIV activity was absent and in the tear fluid where it was low, during continuous wearing of contact lenses or repeated irradiation of the cornea with UVB rays, slight DPPIV activity appeared first in the superficial layers of the corneal epithelium, while later increased activity was present in the whole epithelium. This paralleled elevated DPPIV activity in the tear fluid. Moreover, during continuous contact lens wear, the increased DPPIV activity in the tear fluid was, in many cases, coincidental with the presence of capillaries in the limbal part of the corneal stroma. After severe alkali burns when corneal ulcers appeared, collagen fragments were active for DPPIV, which was associated with high DPPIV activity in the tear fluid. In conclusion, Gly-Pro-AFC was found to be useful for comparative histochemical and biochemical studies on DPPIV activity in the experimentally injured rabbit eye. Using the method of the tear film collection by a short touch of substrate punches to the respective site of the cornea or conjunctiva we can show that in experimental injuries (wearing of contact lenses, irradiation of the cornea with UVB rays), the damaged corneal cells were the main source for DPPIV activity in the tear fluid. It is suggested that the activity of DPPIV measured in the tear fluid might serve as an indicator of early corneal disorders, e.g. corneal vascularization related to contact lens wear

Computer Supported Dental Reconstruction in the Patients with Abrasion and Temporomandibular Joint Disorders (A Case Report)

Temporomandibular disorders are quiet common complaints which lead our patients to the clinicians. The most frequent troubles are pain, acoustic phenomenon, or changes on the hard dental tissues.Before any treatment are very important all the anamnesis data, detailed occlusal analysis and plan treatment. In our case report we show step by step treatment procedure where we increased secondary lowered bite thanks to all-ceramic crowns