- Health Professional Education, Signal Processing, Image Science, Medical Genetics, F Mri, Evaluation Research, and 37 morePhysics, Mathematics, Computer Science, Business, Complex Systems Science, Biomedicine, Magnetic Resonance Imaging, Informatics, Medical Imaging, Artificial Intelligence, Information Systems, Public Health, Bioinformatics, Neuroscience, Applied Mathematics, Computer Graphics, Oncology, Teaching and Learning, Visualization, Virtual Reality (Computer Graphics), Educational Informatics, Augmented Reality, Statistics, Neuroimaging, Project Management, Innovation statistics, Networks, Metabolomics, Graph Theory, AdHoc Networks, Random Graph Theory, Magnetic Resonance Spectroscopy, Software Engineering, Intelligent Vehicular networks, Software Engineering education, Computational Biology, and Biomedical Engineering(Physics, Mathematics, Computer Science, Business, Complex Systems Science, Biomedicine, Magnetic Resonance Imaging, Informatics, Medical Imaging, Artificial Intelligence, Information Systems, Public Health, Bioinformatics, Neuroscience, Applied Mathematics, Computer Graphics, Oncology, Teaching and Learning, Visualization, Virtual Reality (Computer Graphics), Educational Informatics, Augmented Reality, Statistics, Neuroimaging, Project Management, Innovation statistics, Networks, Metabolomics, Graph Theory, AdHoc Networks, Random Graph Theory, Magnetic Resonance Spectroscopy, Software Engineering, Intelligent Vehicular networks, Software Engineering education, Computational Biology, and Biomedical Engineering)edit
The Tommy’s National Centre for Miscarriage Research aims to support the diagnosis and treatment for couples suffering from recurrent miscarriage. Tommy’s Net is an electronic data gathering tool, collecting miscarriage data and links... more
The Tommy’s National Centre for Miscarriage Research aims to support the diagnosis and treatment for couples suffering from recurrent miscarriage. Tommy’s Net is an electronic data gathering tool, collecting miscarriage data and links with hospital Clinical Information System databases. The gathering of patient reported data is an important aspect, especially as data relating to pregnancy and miscarriage events are often left unreported. Methods: Both traditional paper-based and electronic patient reported outcome (ePRO) solutions have been explored to improve response rates, minimize data redundancy and reduce burden on staff. Popular ePRO survey solutions have been compared, including REDCap, SurveyMonkey, Qualtrics and LimeSurvey. Results: LimeSurvey was selected as the most appropriate solution as it provided self-hosting capability, SMS integration and ease of use. Conclusion: We have implemented a LimeSurvey based ePRO system for collection of baseline and follow-up data for p...
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Modern healthcare providers rely upon Electronic Healthcare Records (EHR) systems to record patient data inside their own organization. Some healthcare providers share this data to facilitate patient care with other providers. Medical... more
Modern healthcare providers rely upon Electronic Healthcare Records (EHR) systems to record patient data inside their own organization. Some healthcare providers share this data to facilitate patient care with other providers. Medical devices and healthcare providers can use differing standards of recording healthcare information. The Structural and Semantic Mapper Proxy API solution offers a practical way to tackles the issues of Structural and Semantic mapping of Application Programing Interfaces (API) in a healthcare context to enable connection of all existing systems to a healthcare providers EHR creating a single source of truth regarding the treatment of patients and enabling healthcare providers to bridge the gap between external EHR systems.
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Left-ventricular (LV) remodelling, associated with diastolic heart failure, is driven by an increase in myocardial stress. Therefore, normalisation of LV wall stress is the cornerstone of many therapeutic treatments. However, information... more
Left-ventricular (LV) remodelling, associated with diastolic heart failure, is driven by an increase in myocardial stress. Therefore, normalisation of LV wall stress is the cornerstone of many therapeutic treatments. However, information regarding such regional stress-strain for human LV is still limited. Thus, the objectives of our study were to determine local diastolic stress-strain field in healthy LVs, and consequently, to identify the regional variations amongst them due to geometric heterogeneity. Effects of LV base movement on diastolic model predictions, which were ignored in the literature, were further explored. Personalised finite-element modelling of five normal human bi-ventricles was carried out using subject-specific myocardium properties. Model prediction was validated individually through comparison with end-diastolic volume and a new shape-volume based measurement of LV cavity, extracted from magnetic resonance imaging. Results indicated that incorporation of LV b...
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Information flow between the thalamus and cerebral cortex is a crucial component of adaptive brain function, but the details of thalamocortical interactions in human subjects remain unclear. The principal aim of this study was to evaluate... more
Information flow between the thalamus and cerebral cortex is a crucial component of adaptive brain function, but the details of thalamocortical interactions in human subjects remain unclear. The principal aim of this study was to evaluate the agreement between functional thalamic network patterns, derived using seed-based connectivity analysis and independent component analysis (ICA) applied separately to resting state functional MRI (fMRI) data from 21 healthy participants. For the seed-based analysis, functional thalamic parcellation was achieved by computing functional connectivity (FC) between thalamic voxels and a set of pre-defined cortical regions. Thalamus-constrained ICA provided an alternative parcellation. Both FC analyses demonstrated plausible and comparable group-level thalamic subdivisions, in agreement with previous work. Quantitative assessment of the spatial overlap between FC thalamic segmentations, and comparison of each to a histological "gold-standard"...
Research Interests: Neuroscience, Psychology, Computer Science, Artificial Intelligence, Neuroimaging, and 15 moreMagnetic Resonance Imaging, Independent Component Analysis, Medicine, Brain Mapping, Functional Connectivity, Humans, Thalamus, Cerebral Cortex, Female, Neuroimage, Male, Adult, Neural pathways, Psychology and Cognitive Sciences, and Medical and Health Sciences
We present a possible way to study large-size packet-switched networks capable of accounting for interactions between adjacent queues. The interaction between queues arises, because of the influence of the routing protocol on each... more
We present a possible way to study large-size packet-switched networks capable of accounting for interactions between adjacent queues. The interaction between queues arises, because of the influence of the routing protocol on each switching decision, and the stochastic nature of packet lengths and inter-arrival times.Both the methodology and the analysis tools are adaptations of methods of statistical mechanics. The justification for their use lies in recent experimental evidence indicating that aggregate, core-network IP traffic, exhibits quasi-Markovian properties when the network is heavily loaded.In this paper, we present a general methodology and introduce approximations that greatly simplify the analysis. These approximations, are owing to the quasi-Markovian nature of the traffic and the large size of the network.
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Información del artículo The digital classification of ancient near eastern cuneiform data.
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ObjectiveRemote or mobile consulting (mConsulting) is being promoted to strengthen health systems, deliver universal health coverage and facilitate safe clinical communication during COVID-19 and beyond. We explored whether mConsulting is... more
ObjectiveRemote or mobile consulting (mConsulting) is being promoted to strengthen health systems, deliver universal health coverage and facilitate safe clinical communication during COVID-19 and beyond. We explored whether mConsulting is a viable option for communities with minimal resources in low- and middle-income countries (LMICs).MethodsWe reviewed evidence published since 2018 about mConsulting in LMICs and undertook a scoping study (pre-COVID) in two rural settings (Pakistan, Tanzania) and five urban slums (Kenya, Nigeria, Bangladesh), using policy/document review, secondary analysis of survey data (from the urban sites), and thematic analysis of interviews/workshops with community members, healthcare workers, digital/telecommunications experts, mConsulting providers, local and national decision-makers. Project advisory groups guided the study in each country.ResultsWe reviewed five empirical studies and seven reviews, analysed data from 5,219 urban slum households and engag...
CAREPATH project is focusing on providing an integrated solution for sustainable care for multimorbid elderly patients with dementia or mild cognitive impairment. The project has a digitally enhanced integrated patient-centered care... more
CAREPATH project is focusing on providing an integrated solution for sustainable care for multimorbid elderly patients with dementia or mild cognitive impairment. The project has a digitally enhanced integrated patient-centered care approach clinical decision and associated intelligent tools with the aim to increase patients’ independence, quality of life and intrinsic capacity. In this paper, the conceptual aspects of the CAREPATH project, in terms of technical and clinical requirements and considerations, are presented.
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There is a need to constantly tackle a range of diverse and, sometimes, contradictory requirements of people with multiple chronic conditions. Integrated Care provides a potential solution to this need and digital technology can be the... more
There is a need to constantly tackle a range of diverse and, sometimes, contradictory requirements of people with multiple chronic conditions. Integrated Care provides a potential solution to this need and digital technology can be the proposition for addressing its implementation challenge. Digital technology can support clinical teams to achieve care across all levels and provide independence in patients’ lives, by supporting them in enhanced and integrated activity within our societal structures.
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Introduction: (comprising context and problem statement) There is an increasing need to organise the care around the patient and not the disease, taking into account his or her multiple physical and psycho-social conditions. An... more
Introduction: (comprising context and problem statement) There is an increasing need to organise the care around the patient and not the disease, taking into account his or her multiple physical and psycho-social conditions. An integrated, patient-centred care and cure delivery architecture needs to be developed considering the realities of multi-morbidity and poly-pharmacy. This needs to address the medical, technological, organisational and socio-economical challenges of creating a collaboration environment for all of the stakeholders involved in the holistic continuum of care. Short description of practice change implemented: The project C3-Cloud (H2020, PHC-25-2015, 689181) aims to enable the development of personalised care plans for multi-morbid conditions supported by innovative ICT components to improve delivery of integrated care services to elderly patients with multi-morbidity through continuous coordination of patient-centred care activities by a multidisciplinary care t...
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The reuse of routinely collected clinical data for clinical research is being explored as part of the drive to reduce duplicate data entry and to start making full use of the big data potential in the healthcare domain. Clinical... more
The reuse of routinely collected clinical data for clinical research is being explored as part of the drive to reduce duplicate data entry and to start making full use of the big data potential in the healthcare domain. Clinical researchers often need to extract data from patient registries and other patient record datasets for data analysis as part of clinical studies. In the TRANSFoRm project, researchers define their study requirements via a Query Formulation Workbench. We use a standardised approach to data extraction to retrieve relevant information from heterogeneous data sources, using semantic interoperability enabled via detailed clinical modelling. This approach is used for data extraction from data sources for analysis and for pre-population of electronic Case Report Forms from electronic health records in primary care clinical systems.
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BACKGROUND There is an increasing need to organise the care around the patient and not the disease, as well as taking into account the complex realities of multiple physical, psycho-social conditions and polypharmacy. Integrated... more
BACKGROUND There is an increasing need to organise the care around the patient and not the disease, as well as taking into account the complex realities of multiple physical, psycho-social conditions and polypharmacy. Integrated patient-centred care delivery platforms have been developed for both patients and clinicians. These platforms could provide a promising way to achieve a collaborative environment that improves the provision of integrated care for patients via enhanced ICT solutions. OBJECTIVE The C3-Cloud project has developed two collaborative computer platforms for patients and members of the Multi-Disciplinary Team and deployed these in three different European settings. The objective of this study is to pilot test the platforms and evaluate their impact on patients, informal caregivers, healthcare professionals and, in extend, healthcare systems. METHODS This paper describes the protocol for conducting an evaluation of the user-centred design, user experience, acceptabil...
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The Learning Health System (LHS) requires integration of research into routine practice. 'eSource' or embedding clinical trial functionalities into routine electronic health record (EHR) systems has long been put forward as a... more
The Learning Health System (LHS) requires integration of research into routine practice. 'eSource' or embedding clinical trial functionalities into routine electronic health record (EHR) systems has long been put forward as a solution to the rising costs of research. We aimed to create and validate an eSource solution that would be readily extensible as part of a LHS. The EU FP7 TRANSFoRm project's approach is based on dual modelling, using the Clinical Research Information Model (CRIM) and the Clinical Data Integration Model of meaning (CDIM) to bridge the gap between clinical and research data structures, using the CDISC Operational Data Model (ODM) standard. Validation against GCP requirements was conducted in a clinical site, and a cluster randomised evaluation by site nested into a live clinical trial. Using the form definition element of ODM, we linked precisely modelled data queries to data elements, constrained against CDIM concepts, to enable automated patient i...
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BRIDG is a widely known domain model of protocol-driven biomedical/clinical research. During a project to design a clinical trials management system for primary care research we developed a standard, computable representation of an... more
BRIDG is a widely known domain model of protocol-driven biomedical/clinical research. During a project to design a clinical trials management system for primary care research we developed a standard, computable representation of an RCT--the Primary Care Research Object Model (PCROM). We compared the PCROM Model to BRIDG and found significant overlap of concepts but also several areas important to our work that were either not yet represented or represented quite differently in BRIDG.
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Enabling successful active ageing is an international priority to meet the challenges of increasing life expectancy. Digital strategies, such as telemedicine and e-health, offer the potential to deliver active ageing in a cost-effective... more
Enabling successful active ageing is an international priority to meet the challenges of increasing life expectancy. Digital strategies, such as telemedicine and e-health, offer the potential to deliver active ageing in a cost-effective manner at scale. This article aims to establish the extent to which the research literature considers e-health-based and telemedicine-based active ageing interventions. A systematic review was conducted according to PRISMA standards. Independently, two authors searched the Cochrane, EMBASE & CINAHL databases, with subsequent independent extraction and semi-quantitative analysis. We report a considerable breadth in digital active ageing research, which is truly international in its scope. There is a diverse range of both interventions and technologies, including a reassuring focus on community-based interventions. Whilst there are a number of quantitative studies, sample sizes are small, with a limited amount of statistical testing of the results. The...
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Aims Magnetic resonance imaging (MRI) is a valuable tool for non-invasive diagnosis of paediatric brain tumours. The rarity of the disease dictates multi-centre studies and imaging biomarkers that are robust to protocol variability. We... more
Aims Magnetic resonance imaging (MRI) is a valuable tool for non-invasive diagnosis of paediatric brain tumours. The rarity of the disease dictates multi-centre studies and imaging biomarkers that are robust to protocol variability. We investigated diffusion tensor MRI (DT-MRI), combined with machine learning, as an aid to diagnosis and evaluated the robustness of the imaging metrics. Method A multi-centre cohort of 52 clinical DT-MRI scans (20 medulloblastomas (MB), 21 pilocytic astrocytomas (PA), 11 ependymomas (EP)) were analysed retrospectively. Histograms for regions of solid tumour for fractional anisotropy (FA), mean diffusivity (MD), pure anisotropic diffusion (q) and pure isotropic diffusion (p) were compared to assess diagnostic capability. Linear discriminate analysis (LDA) was used for classification and validated using leave-one-out-cross-validation (LOOCV). Results Histogram medians for FA, MD, q and p were all different between tumor groups (P<.0001, Kruskal Wallis...
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To determine if apparent diffusion coefficients (ADC) can discriminate between posterior fossa brain tumours on a multicentre basis. A total of 124 paediatric patients with posterior fossa tumours (including 55 Medulloblastomas, 36... more
To determine if apparent diffusion coefficients (ADC) can discriminate between posterior fossa brain tumours on a multicentre basis. A total of 124 paediatric patients with posterior fossa tumours (including 55 Medulloblastomas, 36 Pilocytic Astrocytomas and 26 Ependymomas) were scanned using diffusion weighted imaging across 12 different hospitals using a total of 18 different scanners. Apparent diffusion coefficient maps were produced and histogram data was extracted from tumour regions of interest. Total histograms and histogram metrics (mean, variance, skew, kurtosis and 10th, 20th and 50th quantiles) were used as data input for classifiers with accuracy determined by tenfold cross validation. Mean ADC values from the tumour regions of interest differed between tumour types, (ANOVA P
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Objective To analyse mortality statistics in the United Kingdom during the initial phases of the severe acute respiratory coronavirus 2 (SARS-CoV-2) pandemic and to understand the impact of the pandemic on national mortality. Methods... more
Objective To analyse mortality statistics in the United Kingdom during the initial phases of the severe acute respiratory coronavirus 2 (SARS-CoV-2) pandemic and to understand the impact of the pandemic on national mortality. Methods Retrospective review of weekly national mortality statistics in the United Kingdom over the past 5 years, including subgroup analysis of respiratory mortality rates. Results During the early phases of the SARS-CoV-2 pandemic in the first months of 2020, there were consistently fewer deaths per week compared with the preceding 5 years. This pattern was not observed at any other time within the past 5 years. We have termed this phenomenon the “SARS-CoV-2 paradox.” We postulate potential explanations for this seeming paradox and explore the implications of these data. Conclusions Paradoxically, but potentially importantly, lower rather than higher weekly mortality rates were observed during the early stages of the SARS-CoV-2 pandemic. This paradox may have...
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Note: OCR errors may be found in this Reference List extracted from the full text article. ACM has opted to expose the complete List rather than only correct and linked references. ... [1] EH Shortliffe, Health Care and the Next... more
Note: OCR errors may be found in this Reference List extracted from the full text article. ACM has opted to expose the complete List rather than only correct and linked references. ... [1] EH Shortliffe, Health Care and the Next Generation Internet, Annals of Internal Medicine ...
A tool for diagnosing childhood cerebellar tumours using magnetic resonance (MR) spectroscopy peak height measurement has been developed based on retrospective analysis of single-centre data. To determine the diagnostic accuracy of the... more
A tool for diagnosing childhood cerebellar tumours using magnetic resonance (MR) spectroscopy peak height measurement has been developed based on retrospective analysis of single-centre data. To determine the diagnostic accuracy of the peak height measurement tool in a multicentre prospective study, and optimise it by adding new prospective data to the original dataset. Magnetic resonance imaging (MRI) and single-voxel MR spectroscopy were performed on children with cerebellar tumours at three centres. Spectra were processed using standard scanner software and peak heights for N-acetyl aspartate, creatine, total choline and myo-inositol were measured. The original diagnostic tool was used to classify 26 new tumours as pilocytic astrocytoma, medulloblastoma or ependymoma. These spectra were subsequently combined with the original dataset to develop an optimised scheme from 53 tumours in total. Of the pilocytic astrocytomas, medulloblastomas and ependymomas, 65.4% were correctly assig...
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Older age is associated with an increased accumulation of multiple chronic conditions. The clinical management of patients suffering from multiple chronic conditions is very complex, disconnected and time-consuming with the traditional... more
Older age is associated with an increased accumulation of multiple chronic conditions. The clinical management of patients suffering from multiple chronic conditions is very complex, disconnected and time-consuming with the traditional care settings. Integrated care is a means to address the growing demand for improved patient experience and health outcomes of multimorbid and long-term care patients. Care planning is a prevalent approach of integrated care, where the aim is to deliver more personalized and targeted care creating shared care plans by clearly articulating the role of each provider and patient in the care process. In this paper, we present a method and corresponding implementation of a semi-automatic care plan management tool, integrated with clinical decision support services which can seamlessly access and assess the electronic health records (EHRs) of the patient in comparison with evidence based clinical guidelines to suggest personalized recommendations for goals ...
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Identification of in vivo passive biomechanical properties of healthy human myocardium from regular clinical data is essential for subject-specific modelling of left ventricle (LV). In this work, myocardium was defined by Holzapfel-Ogden... more
Identification of in vivo passive biomechanical properties of healthy human myocardium from regular clinical data is essential for subject-specific modelling of left ventricle (LV). In this work, myocardium was defined by Holzapfel-Ogden constitutive law. Therefore, the objectives of the study were (a) to estimate the ranges of the constitutive parameters for healthy human myocardium using non-invasive routine clinical data, and (b) to investigate the effect of geometry, LV end-diastolic pressure (EDP) and fibre orientations on estimated values. In order to avoid invasive measurements and additional scans, LV cavity volume, measured from routine MRI, and empirical pressure-normalised-volume relation (Klotz-curve) were used as clinical data. Finite element modelling, response surface method and genetic algorithm were used to inversely estimate the constitutive parameters. Due to the ill-posed nature of the inverse optimisation problem, the myocardial properties was extracted by ident...
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Brain tumours are the most common solid cancers in children in the UK and are the most common cause of cancer deaths in this age group. Despite current advances in MRI, non-invasive diagnosis of paediatric brain tumours has yet to find... more
Brain tumours are the most common solid cancers in children in the UK and are the most common cause of cancer deaths in this age group. Despite current advances in MRI, non-invasive diagnosis of paediatric brain tumours has yet to find its way into routine clinical practice. Radiomics, the high-throughput extraction and analysis of quantitative image features (e.g. texture), offers potential solutions for tumour characterization and decision support. In the search for diagnostic oncological markers, the primary aim of this work was to study the application of MRI texture analysis (TA) for the classification of paediatric brain tumours. A multicentre study was carried out, within a supervised classification framework, on clinical MR images, and a support vector machine (SVM) was trained with 3D textural attributes obtained from conventional MRI. To determine the cross-centre transferability of TA, an assessment of how SVM performs on unseen datasets was carried out through rigorous p...
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Public access defibrillation initiatives make automated external defibrillators available to the public. This facilitates earlier defibrillation of out-of-hospital cardiac arrest victims and could save many lives. It is currently only... more
Public access defibrillation initiatives make automated external defibrillators available to the public. This facilitates earlier defibrillation of out-of-hospital cardiac arrest victims and could save many lives. It is currently only used for a minority of cases. The aim of this systematic review was to identify barriers and facilitators to public access defibrillation. A comprehensive literature review was undertaken defining formal search terms for a systematic review of the literature in March 2017. Studies were included if they considered reasons affecting the likelihood of public access defibrillation and presented original data. An electronic search strategy was devised searching MEDLINE and EMBASE, supplemented by bibliography and related-article searches. Given the low-quality and observational nature of the majority of articles, a narrative review was performed. Sixty-four articles were identified in the initial literature search. An additional four unique articles were id...
The paper presents a concise method for transforming textual representations of healthcare services, to a structured, semantically unambiguous modelling language. The method is designed based on literature, as well as trial and error by... more
The paper presents a concise method for transforming textual representations of healthcare services, to a structured, semantically unambiguous modelling language. The method is designed based on literature, as well as trial and error by the authors, using text descriptions of healthcare services. Employing the method can convert textual descriptions to structured graphical models, facilitating stakeholder collaboration on requirements analysis and simulation.
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As patient numbers continue to rise Emergency Department's (ED's) are struggling to not only control patient wait times but also to maintain the quality of patient care. Improving patient flow through the ED has been a priority... more
As patient numbers continue to rise Emergency Department's (ED's) are struggling to not only control patient wait times but also to maintain the quality of patient care. Improving patient flow through the ED has been a priority for many years with techniques such as Lean Six-Sigma being implemented specifically to help alleviate the problem. The Institute for Healthcare Improvement recently stated that the best opportunities to improving patient flow relate to the front-end of the ED, namely triage. This contribution examines the use of Telehealth initiatives at the front-end of the ED, specifically tele-consultation, to reduce patient loading, provide timelier healthcare (with improved patient outcomes) and reduce costs.
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Integrated care paradigms depend on multiple sources of data. The quality of data used in decision-making will ultimately affect the delivered care to the patient. Quality includes several dimensions, which may affect the result. This... more
Integrated care paradigms depend on multiple sources of data. The quality of data used in decision-making will ultimately affect the delivered care to the patient. Quality includes several dimensions, which may affect the result. This paper presents how data quality dimensions may affect the delivered service, and propose a conceptual framework for the classification of confidence in data used in clinical decision-making for integrated care.
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3T magnetic resonance scanners have boosted clinical application of (1) H-MR spectroscopy (MRS) by offering an improved signal-to-noise ratio and increased spectral resolution, thereby identifying more metabolites and extending the range... more
3T magnetic resonance scanners have boosted clinical application of (1) H-MR spectroscopy (MRS) by offering an improved signal-to-noise ratio and increased spectral resolution, thereby identifying more metabolites and extending the range of metabolic information. Spectroscopic data from clinical 1.5T MR scanners has been shown to discriminate between pediatric brain tumors by applying machine learning techniques to further aid diagnosis. The purpose of this multi-center study was to investigate the discriminative potential of metabolite profiles obtained from 3T scanners in classifying pediatric brain tumors. A total of 41 pediatric patients with brain tumors (17 medulloblastomas, 20 pilocytic astrocytomas, and 4 ependymomas) were scanned across four different hospitals. Raw spectroscopy data were processed using TARQUIN. Borderline synthetic minority oversampling technique was used to correct for the data skewness. Different classifiers were trained using linear discriminative anal...
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A terminology service makes diverse terminologies/ontologies accessible under a uniform interface. The EUTRANSFoRm project built an online terminology service for European primary care research. The service experienced performance... more
A terminology service makes diverse terminologies/ontologies accessible under a uniform interface. The EUTRANSFoRm project built an online terminology service for European primary care research. The service experienced performance limitations during its operation. Based on community feedback, we evaluated alternative solutions and developed a new version of the service. Based on BioPortal's scalable infrastructure, the new service delivers more features with improved performance and reduced maintenance cost. We plan to extend the service to meet Fast Healthcare Interoperability Resources specifications.
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The paper illustrates how event tree diagrams, used in safety engineering, can be applied to test the design of a healthcare service. Event tree diagrams can be employed to inform quantitative approaches to quality, by providing... more
The paper illustrates how event tree diagrams, used in safety engineering, can be applied to test the design of a healthcare service. Event tree diagrams can be employed to inform quantitative approaches to quality, by providing justification with respect to safety, of operational aspects to be monitored and measured.
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In cases of emergency, such as out-of-hospital cardiac arrests, the first few minutes are crucial for victims to receive care and have a positive outcome. However, emergency services often arrive on scene after those first few minutes,... more
In cases of emergency, such as out-of-hospital cardiac arrests, the first few minutes are crucial for victims to receive care and have a positive outcome. However, emergency services often arrive on scene after those first few minutes, making any bridging solutions key. Finding a defibrillator or accessing a trained volunteer responder are some of the technological solutions that are being developed to support the chain of survival. This paper looks at technologies, in particular those linked to mobile apps that have been used to locate defibrillators and responder apps that enable responders to attend to nearby emergencies. We review a selection of apps and also assess the challenges and considerations for such apps.
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This study characterises the inpatient discharge process for medical patients. Inpatient discharge represents a highly complex, distinct process at the point of transition to community care. It is poorly understood. Data were collected to... more
This study characterises the inpatient discharge process for medical patients. Inpatient discharge represents a highly complex, distinct process at the point of transition to community care. It is poorly understood. Data were collected to assess the discharge patterns of 3386 patients admitted to a tertiary referral centre over a 9 day period. Individual patient parameters were extracted from an Electronic Patient Record and analysed for a random stratified sample of (n=150) with 12 months follow-up. Medical discharges represent 37% of non-elective discharges. 36% fewer medical discharges occurred at weekends (p<0.01), patients discharged at weekends were less complex. 63% of discharges had follow up plans. GP follow up was planned for 61% of single admissions compared to 32% of patients who subsequently were readmitted. Health informatics approaches are critical to improving understanding, quality and efficiency of the discharge process.
Research Interests: Information Systems, General Practice, Electronic Health Records, Library and Information Studies, Humans, and 10 moreFemale, Male, Aged, Middle Aged, Public health systems and services research, Time Factors, Continuity of Patient Care, Medication Reconciliation, Socioeconomic Factors, and Patient discharge
Abstract In recent years, there has been widespread interest and a large number of publications on the application of graph theory techniques into constructing and analyzing biologically-informed gene networks from cancer cell line data... more
Abstract In recent years, there has been widespread interest and a large number of publications on the application of graph theory techniques into constructing and analyzing biologically-informed gene networks from cancer cell line data sets. Current research efforts have predominantly looked at an overall static, topological, representation of the network, and have not investigated the application of graph theoretical techniques to evolutionary investigations of cancer. A number of these studies have used graph theory metrics, such ...
Research Interests: Bioinformatics, Graph Theory, Genomics, Cancer, Biology, and 3 moreCorrelation, Measurement, and Gene Network
The improved understanding of the whole healthcare and wellbeing pathway for individuals depends on the power of healthcare information, being made readily available and easily interpretable by both humans and machines. In the centre of... more
The improved understanding of the whole healthcare and wellbeing pathway for individuals depends on the power of healthcare information, being made readily available and easily interpretable by both humans and machines. In the centre of this challenge lies the concept of interoperability, as a way to provide fundamental linkage, integration and meaningful use of healthcare data between systems, organisations and users. In particular, semantic interoperability can offer a way of enriching healthcare data with context and meaning, in order to achieve enhanced understanding and better evidence-based interpretation of disease and wellbeing for an individual, within the context of healthcare provision and clinical research. In this keynote paper, the concept of semantic interoperability, for healthcare data linkage and exchange, is critically discussed. An emphasis is given on the importance of clinical terminologies and associated services, as means for adding meaning to routinely collected clinical data.
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... In Diffserv and Liang Ji and Theodoros N. Arvanitis and Costas C. Constantinou}, title = {ANNALS OF MATHEMATICS, COMPUTING TELEINFORMATICS, VOL 2 ... 1998. 163, Making greed work in networks: A game-theoretic analysis of switch... more
... In Diffserv and Liang Ji and Theodoros N. Arvanitis and Costas C. Constantinou}, title = {ANNALS OF MATHEMATICS, COMPUTING TELEINFORMATICS, VOL 2 ... 1998. 163, Making greed work in networks: A game-theoretic analysis of switch service disciplines Shenker - 1995. ...