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Use Technology to Help Medical Staff Treat "New Health Problems" Arising Constantly. 利用技术帮助医务人员治疗不断出现的 "新健康问题"。
Pub Date : 2024-11-22 DOI: 10.3233/SHTI241067
Nikitas N Karanikolas

The development of medical science allows the treatment of more and more health problems that in the past were not a factor of consumption of health resources, because at that time medical science did not have protocols for their treatment. Health problems that are now treatable, hereafter referred as "new health problems", often affect large population groups and require increased consumption of health resources. It therefore becomes necessary to increase the number of staff providing health services (doctors, nurses, etc.) and other resources. This raises the question: is it feasible to manage the "new health problems" by the existing medical staff? If not, are there other solutions? Could technology help the existing Medical Staff to sufficiently manage the "new health problems"? We will examine a pilot system "Recording and visualizing of outpatient monitoring data with smart mobile phones", which seeks to ensure the competence of existing medical staff in the effective treatment of the ever-increasing volume of transplant patients.

随着医学科学的发展,越来越多的健康问题可以得到治疗,而这些问题在过去并不 是消耗卫生资源的因素,因为当时的医学科学还没有治疗这些问题的方案。现在可以治疗的健康问题(以下简称 "新健康问题")往往影响到大量人口,需要消耗更多的医疗资源。因此,有必要增加提供医疗服务的人员(医生、护士等)和其他资源。这就提出了一个问题:现有医务人员管理 "新的健康问题 "是否可行?如果不可行,还有其他解决办法吗?技术能否帮助现有医务人员充分管理 "新的健康问题"?我们将研究 "利用智能手机记录和显示门诊病人监测数据 "试点系统,该系统旨在确保现有医务人员有能力有效治疗日益增多的移植病人。
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引用次数: 0
Mapping of Health System Performance Indicators to the WHO HSPA Framework. 卫生系统绩效指标与世界卫生组织 HSPA 框架的映射。
Pub Date : 2024-11-22 DOI: 10.3233/SHTI241050
Lucien Adam, Anthéa Helene Leung, Murat Sariyar

Healthcare systems worldwide face escalating costs and demographic changes, necessitating effective evaluation tools to understand their underlying challenges. Switzerland's high-quality yet costly healthcare system underscores the need for robust assessment methods. Existing international rankings often lack transparency and comparability, highlighting the value of structured frameworks like the Health System Performance Assessment (HSPA) by the World Health Organization (WHO). This framework evaluates healthcare systems across multiple dimensions including governance, resource generation, financing, and service delivery. This paper aims to integrate Swiss healthcare indicators from the Swiss Health Observatory (Obsan) into the HSPA framework, addressing the central research question: How can these indicators be mapped to the HSPA framework, and what insights does this integration provide? Our methodology includes selecting and categorizing Obsan indicators, manually mapping them to HSPA sub-functions, and validating these mappings using word embeddings and cosine similarity. An R Shiny application was developed for interactive visualization. Results demonstrate accurate indicator assignment, enabling intuitive visualization and enhancing data structuring.

全世界的医疗保健系统都面临着成本上升和人口结构变化的问题,因此需要有效的评估工具来了解其背后的挑战。瑞士的医疗保健系统质量高但成本高,这凸显了对稳健评估方法的需求。现有的国际排名往往缺乏透明度和可比性,这凸显了世界卫生组织(WHO)卫生系统绩效评估(HSPA)等结构化框架的价值。该框架从治理、资源生成、融资和服务提供等多个维度对医疗保健系统进行评估。本文旨在将瑞士卫生观察站(Obsan)的瑞士医疗指标纳入 HSPA 框架,从而解决核心研究问题:如何将这些指标映射到 HSPA 框架中?我们的方法包括选择和分类 Obsan 指标,手动将其映射到 HSPA 子功能,并使用词嵌入和余弦相似性验证这些映射。我们还开发了一个 R Shiny 应用程序,用于交互式可视化。结果表明,指标分配准确,实现了直观的可视化并增强了数据结构。
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引用次数: 0
Handwritten Data Extraction Using OpenAI ChatGPT4o and Robotic Process Automation. 使用 OpenAI ChatGPT4o 和机器人流程自动化提取手写数据。
Pub Date : 2024-11-22 DOI: 10.3233/SHTI241101
Norbert Gal-Nadasan, Vasile Stoicu-Tivadar, Emanuela Gal-Nadasan, Anca Raluca Dinu

This paper proposes to create an Robotic Process Automation style application that can digitalize and extract data from handwritten medical forms. The RPA robot uses OpenAI ChatGPT4o model to extract handwritten medical data and transform it into typed data. The handwritten data is transcribed correctly at a rate of 100%. The data interpretation is accomplished by the UiPath machine learning API. By creating new nonstandard form templates and associated taxonomies the system can be scaled as desired. After the data extraction process the saved data can be sent to a database, spreadsheet. The access to this medical data is restricted to the physicians and medical nurses employed at the medical facility.

本文建议创建一个机器人流程自动化风格的应用程序,它可以从手写医疗表格中数字化并提取数据。RPA 机器人使用 OpenAI ChatGPT4o 模型提取手写医疗数据,并将其转换为打字数据。手写数据的转录正确率达到 100%。数据解释由 UiPath 机器学习 API 完成。通过创建新的非标准表单模板和相关分类标准,该系统可根据需要进行扩展。数据提取过程结束后,保存的数据可以发送到数据库或电子表格中。这些医疗数据的访问权限仅限于医疗机构的医生和护士。
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引用次数: 0
Development of an AI Platform for Advanced Breast Cancer Management. 开发用于晚期乳腺癌管理的人工智能平台。
Pub Date : 2024-11-22 DOI: 10.3233/SHTI241095
Thomas Alassane Ouattara, Seydou Golo Barro, Pascal Staccini

This article explores the transition from a traditional histopathological examination system to an innovative platform using artificial intelligence (AI) for breast cancer detection from histopathological images in Burkina Faso. The existing system is analyzed in detail, highlighting the steps of querying, sample preparation, analysis by the pathologist, and validation by the physician. From this analysis, the needs and challenges are identified, emphasizing the opportunities for AI to improve the efficiency and accuracy of the diagnosis. The design of the AI platform is then presented, including data collection, AI model development, and its integration into existing processes. Finally, the expected results and implications for improving healthcare in Burkina Faso are discussed, highlighting the potential benefits and challenges to overcome for the successful adoption of this promising technology.

本文探讨了布基纳法索从传统的组织病理学检查系统过渡到使用人工智能(AI)从组织病理学图像检测乳腺癌的创新平台的过程。文章详细分析了现有系统,重点介绍了查询、样本准备、病理学家分析和医生验证等步骤。通过分析,确定了需求和挑战,强调了人工智能提高诊断效率和准确性的机会。然后介绍了人工智能平台的设计,包括数据收集、人工智能模型开发及其与现有流程的整合。最后,讨论了预期成果和对改善布基纳法索医疗保健的影响,强调了成功采用这一前景广阔的技术的潜在好处和需要克服的挑战。
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引用次数: 0
Suitability of the OMOP Common Data Model for Mapping Datasets of Medical Research Studies Using the Example of a Multicenter Registry. 以多中心登记处为例,说明 OMOP 通用数据模型在映射医学研究数据集方面的适用性。
Pub Date : 2024-11-22 DOI: 10.3233/SHTI241086
Milla Kurtz, Alfred Winter, Matthias Löbe

Common Data Models (CDM) are developed to solve integration problems that arise in the secondary use of health data. The OMOP CDM is such a model that is mainly used for healthcare data, so this paper examines whether it is also suitable for mapping research data. An exemplary research dataset is mapped to the model and the model is tested for suitability. For this purpose, an ETL process is first designed with the OHDSI tools and finally implemented with Talend Open Studio for Data Integration. The data quality is checked, and the mapping and the model, together with the tools, are evaluated. Overall, all but three data fields from the source dataset could be mapped to the OMOP model, so that the model's suitability for research data can be confirmed.

通用数据模型(CDM)的开发是为了解决医疗数据二次利用过程中出现的整合问题。OMOP CDM 就是这样一个主要用于医疗保健数据的模型,因此本文将研究它是否也适合映射研究数据。我们将一个示范性研究数据集映射到该模型中,并测试该模型是否适用。为此,首先使用 OHDSI 工具设计了一个 ETL 流程,最后使用 Talend Open Studio for Data Integration 实现了该流程。对数据质量进行检查,并对映射和模型以及工具进行评估。总体而言,除了三个数据字段外,源数据集的所有数据字段都可以映射到 OMOP 模型,因此可以确认该模型适用于研究数据。
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引用次数: 0
Measurement of Cumulative Drug Exposure from Clinical Data Warehouse. 从临床数据仓库中测量累积药物暴露。
Pub Date : 2024-11-22 DOI: 10.3233/SHTI241085
Mathilde Bories, Aurélie Bannay, Morgane Pierre-Jean, Guillaume Bouzille, Pascal Le Corre

Polypharmacy (PP) and hyperpolypharmacy (HPP), are prevalent among cancer patients and are associated with an increased risk of drug-drug interactions (DDI) and potentially inappropriate medications (PIM). This study aimed to characterize PP, HPP, DDI, and PIM in patients with hematological malignancies hospitalized for hematopoietic stem cell transplantation (HSCT) by introducing a novel metric: cumulative drug exposure. Clinical data warehouse (CDW) records were employed to develop algorithms that quantified patients' cumulative exposure to these prescribing determinants during hospitalization. This entailed determining the number of days during the hospital stay when the patient was exposed to PP, HPP, PIM and/or DDI. For PIM and DDI, the number of PIMs or DDIs administered per day was taken into account in this calculation. Among 339 HSCT patients, PP and HPP were highly prevalent (over 67% of HSCT patients), almost all patients experienced DDI (over 98% of HSCT patients) and almost all elderly patients were exposed to PIM (over 98% of HSCT patients). Cumulative drug exposure differed between allogeneic and autologous HSCT patients, with allogeneic patients being more exposed to HPP (28.5 days vs 4.7 days for autologous HSCT patients) and DDI (255.6 days vs 58.4 for autologous HSCT patients). This study proposes a novel approach to assessing the impact of prescribing determinants on patient outcomes and provides insights for future research into the association between drug exposure and adverse events. Indeed, the use of cumulative drug exposure as a metric provides a comprehensive view of patient exposure throughout hospitalization, thereby enhancing understanding of the impact of prescribing practices on clinical outcomes.

多药(PP)和超多药(HPP)在癌症患者中很普遍,与药物相互作用(DDI)和潜在用药不当(PIM)风险增加有关。本研究旨在通过引入一种新的指标:累积药物暴露量,描述因造血干细胞移植(HSCT)住院的血液恶性肿瘤患者的PP、HPP、DDI和PIM的特征。临床数据仓库(CDW)记录用于开发算法,量化患者在住院期间对这些处方决定因素的累积暴露。这就需要确定患者住院期间接触 PP、HPP、PIM 和/或 DDI 的天数。对于 PIM 和 DDI,计算时要考虑到每天使用的 PIM 或 DDI 的次数。在 339 名造血干细胞移植患者中,PP 和 HPP 的发病率很高(占造血干细胞移植患者的 67% 以上),几乎所有患者都经历过 DDI(占造血干细胞移植患者的 98% 以上),几乎所有老年患者都接触过 PIM(占造血干细胞移植患者的 98% 以上)。异基因造血干细胞移植患者和自体造血干细胞移植患者的累积药物暴露量不同,异基因造血干细胞移植患者的HPP(28.5天,自体造血干细胞移植患者为4.7天)和DDI(255.6天,自体造血干细胞移植患者为58.4天)暴露量更高。这项研究提出了一种新方法来评估处方决定因素对患者预后的影响,并为今后研究药物暴露与不良事件之间的关联提供了启示。事实上,使用累积药物暴露作为衡量标准可以全面了解患者在整个住院期间的药物暴露情况,从而加深对处方实践对临床结果影响的理解。
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引用次数: 0
Pill Dispenser with Telecare Extension. 带远程护理扩展功能的配药机。
Pub Date : 2024-11-22 DOI: 10.3233/SHTI241074
Sebastian-Bogdan Zigrea, Vasile Stoicu-Tivadar

The existing pill dispenser systems help elderly people to improve their quality of life, and medication adherence. But these systems lack interactive capabilities with caregivers, a crucial element in comprehensive home care management. The suggested CareConnect aims to bridge this gap by introducing a Telecare extension that not only manages medication adherence but also facilitates interaction between the patient and their caregivers. The system is described in terms of this new approach, the functions, hardware and software. The operation of the system is briefly described. A discussion about the advantages of CareConnect system and the future development directions is finally done as a conclusion.

现有的配药系统可以帮助老年人提高生活质量和服药依从性。但这些系统缺乏与护理人员的互动功能,而这正是全面家庭护理管理的关键因素。建议的 CareConnect 系统旨在弥补这一不足,它引入了远程护理扩展功能,不仅能管理服药情况,还能促进病人与护理人员之间的互动。本文将从这一新方法、功能、硬件和软件等方面对该系统进行介绍。此外,还简要介绍了系统的运行情况。最后讨论了 CareConnect 系统的优势和未来的发展方向。
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引用次数: 0
Securing a Generative AI-Powered Healthcare Chatbot. 确保生成式人工智能医疗聊天机器人的安全。
Pub Date : 2024-11-22 DOI: 10.3233/SHTI241091
Georgios Feretzakis, Athanasios Anastasiou, Stavros Pitoglou, Evgenia Paxinou, Aris Gkoulalas-Divanis, Konstantinos Kalodanis, Ioannis Tsapelas, Dimitris Kalles, Vassilios S Verykios

In Generative Artificial Intelligence (AI), Large Language Models (LLMs) like GPT-4, Gemini, Claude, and Llama, significantly impact healthcare by aiding in patient care, medical research, and administrative tasks. AI-powered chatbots offer real-time responses and manage chronic diseases, improving patient outcomes and operational efficiency. However, these models pose security and ethical challenges, necessitating robust data privacy, adversarial training, and ethical guidelines. This paper proposes a secure, ethical pipeline for deploying AI healthcare chatbots, integrating advanced privacy-preserving techniques and continuous security assessments to enhance data privacy, resilience, and user trust.

在生成式人工智能(AI)领域,大型语言模型(LLM),如 GPT-4、Gemini、Claude 和 Llama,通过协助病人护理、医学研究和管理任务,对医疗保健产生了重大影响。人工智能驱动的聊天机器人可提供实时响应并管理慢性疾病,从而改善患者的治疗效果并提高运营效率。然而,这些模型带来了安全和伦理挑战,需要强大的数据隐私、对抗性训练和伦理准则。本文提出了一种用于部署人工智能医疗聊天机器人的安全、道德管道,整合了先进的隐私保护技术和持续的安全评估,以增强数据隐私、弹性和用户信任。
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引用次数: 0
Survival Stacking Ensemble Model for Lung Cancer Risk Prediction. 用于肺癌风险预测的生存期叠加集合模型
Pub Date : 2024-11-22 DOI: 10.3233/SHTI241083
Eduardo Alonso, Xabier Calle, Ibai Gurrutxaga, Andoni Beristain

The most well-established risk factor for lung cancer (LC) is smoking, responsible for approximately 85% of cases. The Lung Cancer Risk Assessment Tool (LCRAT) is a key advancement in this field, which predicts individual risk based on factors like smoking habits, demographic details, personal and family medical history, and environmental exposures. This paper proposes a model with fewer features that improves state of the art performance, using a simplified stacking ensemble, making it more accessible and easier to implement in routine healthcare practice. The data used in this work were derived from two cohorts in the United States: The National Lung Screening Trial (NLST) and the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. Both our model and LCRAT achieve an AUC of 0.799 and 0.782 on test respectively. In terms of percentage of positives, in the 50% of the population, both detect 0.766 and 0.754 of the cases. The ensemble of different survival models enhances robustness by mitigating the weakness of individual models and directly impacts the efficiency of the model, increasing the efficiency and generalizability.

肺癌(LC)最常见的风险因素是吸烟,约 85% 的病例都与吸烟有关。肺癌风险评估工具(LCRAT)是该领域的一项重要进展,它可根据吸烟习惯、人口统计学细节、个人和家族病史以及环境暴露等因素预测个人风险。本文提出了一种功能较少的模型,它采用简化的堆叠组合,提高了技术性能,使其更易于在常规医疗实践中使用。这项工作中使用的数据来自美国的两个队列:美国国家肺癌筛查试验(NLST)和前列腺癌、肺癌、结直肠癌和卵巢癌筛查试验(PLCO)。我们的模型和 LCRAT 在测试中的 AUC 分别为 0.799 和 0.782。就阳性比例而言,在 50%的人群中,两者分别检测出 0.766 和 0.754 个病例。不同生存模型的集合通过减轻单个模型的弱点而增强了稳健性,并直接影响到模型的效率,提高了效率和普适性。
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引用次数: 0
A Neurosurgical Instrument Segmentation Approach to Assess Microsurgical Movements. 评估显微手术移动的神经外科器械分割方法。
Pub Date : 2024-11-22 DOI: 10.3233/SHTI241089
Gleb Danilov, Oleg Pilipenko, Vasiliy Kostyumov, Sergey Trubetskoy, Narek Maloyan, Bulat Nutfullin, Eugeniy Ilyushin, David Pitskhelauri, Alexandra Zelenova, Andrey Bykanov

The ability to recognize anatomical landmarks, microsurgical instruments, and complex scenes and events in a surgical wound using computer vision presents new opportunities for studying microsurgery effectiveness. In this study, we aimed to develop an artificial intelligence-based solution for detecting, segmenting, and tracking microinstruments using a neurosurgical microscope. We have developed a technique to process videos from microscope camera, which involves creating a segmentation mask for the instrument and subsequently tracking it. We compared two segmentation approaches: (1) semantic segmentation using Visual Transformers (pre-trained domain-specific EndoViT model), enhanced with tracking as described by Cheng Y. et al. (our proposed approach), and (2) instance segmentation with tracking based on the YOLOv8l-seg architecture. We conducted experiments using the CholecSeg8k dataset and our proprietary set of neurosurgical videos (PSNV) from microscope. Our approach with tracking outperformed YOLOv8l-seg-based solutions and EndoViT model with no tracking on both CholecSeg8k (mean IoT = 0.8158, mean Dice = 0.8657) and PSNV (mean IoT = 0.7196, mean Dice = 0.8202) datasets. Our experiments with identifying neurosurgical instruments in a microscope's field of view showcase the high quality of these technologies and their potential for valuable applications.

利用计算机视觉识别解剖地标、显微手术器械以及手术伤口中的复杂场景和事件的能力,为研究显微手术的有效性提供了新的机遇。在这项研究中,我们旨在开发一种基于人工智能的解决方案,用于使用神经外科显微镜检测、分割和跟踪显微器械。我们开发了一种处理显微镜摄像头视频的技术,包括为器械创建一个分割掩膜,然后对其进行追踪。我们比较了两种分割方法:(1) 使用 Visual Transformers(预先训练好的特定领域 EndoViT 模型)进行语义分割,并按照 Cheng Y. 等人的方法(我们提出的方法)进行跟踪增强;(2) 基于 YOLOv8l-seg 架构的实例分割与跟踪。我们使用 CholecSeg8k 数据集和我们专有的显微镜神经外科视频集(PSNV)进行了实验。在 CholecSeg8k 数据集(平均 IoT = 0.8158,平均 Dice = 0.8657)和 PSNV 数据集(平均 IoT = 0.7196,平均 Dice = 0.8202)上,我们的跟踪方法优于基于 YOLOv8l-seg 的解决方案和无跟踪的 EndoViT 模型。我们在显微镜视场中识别神经外科器械的实验展示了这些技术的高质量及其有价值的应用潜力。
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引用次数: 0
期刊
Studies in health technology and informatics
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