World Academy of Science, Engineering and Technology

Authors: Rusyaizila Ramli, Nasriah Zakaria, Putra Sumari

Abstract:

Privacy issues commonly discussed among researchers, practitioners, and end-users in pervasive healthcare. Pervasive healthcare systems are applications that can support patient-s need anytime and anywhere. However, pervasive healthcare raises privacy concerns since it can lead to situations where patients may not be aware that their private information is being shared and becomes vulnerable to threat. We have systematically analyzed the privacy issues and present a summary in tabular form to show the relationship among the issues. The six issues identified are medical information misuse, prescription leakage, medical information eavesdropping, social implications for the patient, patient difficulties in managing privacy settings, and lack of support in designing privacy-sensitive applications. We narrow down the issues and chose to focus on the issue of 'lack of support in designing privacysensitive applications' by proposing a privacy-sensitive architecture specifically designed for pervasive healthcare monitoring systems.

Keywords: Human Factors, Pervasive Healthcare, PrivacyIssues

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Authors: N.E.Galich

Abstract:

We develop new nonlinear methods of immunofluorescence analysis for a sensitive technology of respiratory burst reaction of DNA fluorescence due to oxidative activity in the peripheral blood neutrophils. Histograms in flow cytometry experiments represent a fluorescence flashes frequency as functions of fluorescence intensity. We used the Shannon-Weaver index for definition of neutrophils- biodiversity and Hurst index for definition of fractal-s correlations in immunofluorescence for different donors, as the basic quantitative criteria for medical diagnostics of health status. We analyze frequencies of flashes, information, Shannon entropies and their fractals in immunofluorescence networks due to reduction of histogram range. We found the number of simplest universal correlations for biodiversity, information and Hurst index in diagnostics and classification of pathologies for wide spectra of diseases. In addition is determined the clear criterion of a common immunity and human health status in a form of yes/no answers type. These answers based on peculiarities of information in immunofluorescence networks and biodiversity of neutrophils. Experimental data analysis has shown the existence of homeostasis for information entropy in oxidative activity of DNA in neutrophil nuclei for all donors.

Keywords: blood and cells fluorescence in diagnostics ofdiseases, cytometric histograms, entropy and information in fractalnetworks of oxidative activity of DNA, long-range chromosomalcorrelations in living cells.

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Authors: Juan L. Castro, Maria I. NavarroVictor Lopez, Eduardo M. Eisman, Jose M. Zurita

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This paper describes the Multilingual Virtual Simulated Patient framework. It has been created to train the social skills and testing the knowledge of primary health care medical students. The framework generates conversational agents which perform in serveral languages as virtual simulated patients that help to improve the communication and diagnosis skills of the students complementing their training process.

Keywords: Medical training, conversational agents, patient modeling.

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Authors: Yung-Ting Chang, Chung-You Tsai, Yu-Chuan Li

Abstract:

Nosocomial (i.e., hospital-acquired) infections (NI) is a major cause of morbidity and mortality in hospitals. NI rate is higher in intensive care units (ICU) than in the general ward due to patients with severe symptoms, poor immunity, and accepted many invasive therapies. Contact behaviors between health caregivers and patients is one of the infect factors. It is difficult to obtain complete contact records by traditional method of retrospective analysis of medical records. This paper establishes a contact history inferential model (CHIM) intended to extend the use of Proximity Sensing of rapid frequency identification (RFID) technology to transferring all proximity events between health caregivers and patients into clinical events (close-in events, contact events and invasive events).The results of the study indicated that the CHIM can infer proximity care activities into close-in events and contact events. The infection control team could redesign and build optimal workflow in the ICU according to the patient-specific contact history which provided by our automatic tracing system.

Keywords: Active Radio Frequency Identification, Intensive Care Unit, Nosocomial Infections

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Authors: Christopher C. Anyadubalu

Abstract:

Biological, psychological and social experiences and perceptions of healthcare services in patients medically diagnosed of coronary heart disease were investigated using a sample of 10 participants whose responses to the in-depth interview questions were analyzed based on inter-and-intra-case analyses. The results obtained revealed that advancing age, single status, divorce and/or death of spouse and the issue of single parenting negatively impacted patients- biopsychosocial experiences. The patients- experiences of physical signs and symptoms, anxiety and depression, past serious medical conditions, use of self-prescribed medications, family history of poor mental/medical or physical health, nutritional problems and insufficient physical activities heightened their risk of coronary attack. Collectivist culture served as a big source of relieve to the patients. Patients- temperament, experience of different chronic life stresses/challenges, mood alteration, regular drinking, smoking/gambling, and family/social impairments compounded their health situation. Patients were satisfied with the biomedical services rendered by the healthcare personnel, whereas their psychological and social needs were not attended to. Effective procedural treatment model, a holistic and multidimensional approach to the treatment of heart disease patients was proposed.

Keywords: Biopsychosocial, Coronary Heart Disease, Experience, Patients, Perception, Perspective.

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Authors: Alireza Shirvani, Shadi Ebrahimi Mehrabani

Abstract:

In this competitive age, one of the key tools of most successful organizations is knowledge management. Today some organizations measure their current knowledge and use it as an indicator for rating the organization on their reports. Noting that the universities and colleges of medical science have a great role in public health of societies, their access to newest scientific research and the establishment of organizational knowledge management systems is very important. In order to explore the Application of Knowledge Management Factors, a national study was undertaken. The main purpose of this study was to find the rate of the application of knowledge management factors and some ways to establish more application of knowledge management system in Esfahan University-s Medical College (EUMC). Esfahan is the second largest city after Tehran, the capital city of Iran, and the EUMC is the biggest medical college in Esfahan. To rate the application of knowledge management, this study uses a quantitative research methodology based on Probst, Raub and Romhardt model of knowledge management. A group of 267 faculty members and staff of the EUMC were asked via questionnaire. Finding showed that the rate of the application of knowledge management factors in EUMC have been lower than average. As a result, an interview with ten faculty members conducted to find the guidelines to establish more applications of knowledge management system in EUMC.

Keywords: Knowledge, knowledge management, knowledge management factors.

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Authors: Frank C. Pan, Che-Long Su, Ching-Hsuen Chen

Abstract:

Background, measuring an individual-s Health Literacy is gaining attention, yet no appropriate instrument is available in Taiwan. Measurement tools that were developed and used in western countries may not be appropriate for use in Taiwan due to a different language system. Purpose of this research was to develop a Health Literacy measurement instrument specific for Taiwan adults. Methods, several experts of clinic physicians; healthcare administrators and scholars identified 125 common used health related Chinese phrases from major medical knowledge sources that easy accessible to the public. A five-point Likert scale is used to measure the understanding level of the target population. Such measurement is then used to compare with the correctness of their answers to a health knowledge test for validation. Samples, samples under study were purposefully taken from four groups of people in the northern Pingtung, OPD patients, university students, community residents, and casual visitors to the central park. A set of health knowledge index with 10 questions is used to screen those false responses. A sample size of 686 valid cases out of 776 was then included to construct this scale. An independent t-test was used to examine each individual phrase. The phrases with the highest significance are then identified and retained to compose this scale. Result, a Taiwan Health Literacy Scale (THLS) was finalized with 66 health-related phrases under nine divisions. Cronbach-s alpha of each division is at a satisfactory level of 89% and above. Conclusions, factors significantly differentiate the levels of health literacy are education, female gender, age, family members of stroke victims, experience with patient care, and healthcare professionals in the initial application in this study..

Keywords: Health literacy, health knowledge, REALM, THLS.

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Authors: K. Somprasonk, R. Boondiskulchok

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Medical services are usually provided in hospitals; however, in developing country, some rural residences have fewer opportunities to access in healthcare services due to the limitation of transportation communication. Therefore, in Thailand, there are charitable organizations operating to provide medical treatments to these people by shifting the medical services to operation sites; this is commonly known as mobile medical service. Operation routing is important for the organization to reduce its transportation cost in order to focus more on other important activities; for instance, the development of medical apparatus. VRP is applied to solve the problem of high transportation cost of the studied organization with the searching techniques of saving algorithm to find the minimum total distance of operation route and satisfy available time constraints of voluntary medical staffs.

Keywords: Decision Support System, Mobile Medical Service Planning, Saving Algorithm, Vehicle Routing Problem

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Authors: Napisporn Memongkol, Runchana Sinthavalai, Nattapong Seneeratanaprayune Weerawat Ounsaneha, Chanisada Choosuk

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The objective of this research is to develop the performance indicators (PIs) in operational level for the Pre-hospital Emergency Medical Service (EMS) system employing in Thailand. This research started with ascertaining the current pre-hospital care system. The team analyzed the strategies of Narerthorn, a government unit under the ministry of public health, and the existing PIs of the pre-hospital care. Afterwards, the current National Strategic Plan of EMS development (2008-2012) of the Emergency Medical Institute of Thailand (EMIT) was considered using strategic analysis to developed Strategy Map (SM) and identified the Success Factors (SFs). The analysis results from strategy map and SFs were used to develop the Performance Indicators (PIs). To verify the set of PIs, the team has interviewed with the relevant practitioners for the possibilities to implement the PIs. To this paper, it was to ascertain that all the developed PIs support the objectives of the strategic plan. Nevertheless, the results showed that the operational level PIs suited only with the first dimension of National Strategic Plan (infrastructure and information technology development). Besides, the SF was the infrastructure development (to contribute the EMS system to people throughout with standard and efficiency both in normally and disaster conditions). Finally, twenty-nine indicators were developed from the analysis results of SM and SFs.

Keywords: Emergency Medical Service, Performance Indicator, Success Factor, Thailand

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Authors: S. Vijayakumar, M. Sasikala, T. S. Mohammed Saleem, Gurusharan, K. Gauthaman

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The main objective of our study is to collect data about the profile of the asthmatic patients in Assam and thereby have a comprehensive knowledge of the factors influencing the asthmatic patients of the state and their medication pattern. We developed a search strategy to find any publication about the community based survey asthma related and used. These to search the MEDLINE (1996 to current literature) CINAHL DOAJ pubmed databases using the key phrases, Asthma, Respiratory disorders, Drug therapy of Asthma, database decision support system and asthma. The appropriate literature was printed out from the online source and library (Journal) source. The study was conducted through a set of structured and non-structured questionnaires targeted on the asthmatic patients belonging to the rural and urban areas of Assam, during the month of Dec 2006 to July 2007, 138 cases were studied in Gauwathi Medical College & Hospital located in Bhangagarh, Assam in India. The demographic characteristics a factor in 138 patients with asthma with allergic rhinitis (cases) gives the detail profile of asthmatic patient-s distribution of Assam as classified on the basis of age and sex. It is evident from the study that male populations (66%) are more prone to asthma as compared to the females (34%).Another striking features that emerged from this survey is the maximum prevalence of asthma in the age group of 20- 30 years followed by infants belonging to the age group of 7 (0.05%) 0-10years among both male and female populations of Assam. The high incidence of asthma in the age group of 20-30 years may probably be due to the allergy arising out of sudden exposure to dust and pollen which the children face while playing and going to the school. The rural females in the age group of 30-40 years are more prone to asthma than urban females in the same age group may be due to sex differentiation among the tribal population of the state. Pharmacists should educate the asthmatics how to use inhalers considering growing menace of asthma in the state. Safer drugs should be produced in the form of aerosol so that easy administration by the asthmatic patients and physicians of the state is possible for curing asthma. The health centers should be more equipped with the medicines to cure asthma in the state like Assam.

Keywords: Asthma, Respiratory disease, Smoker.

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Authors: Beatriz López, Joaquim Meléndez, Heiko Wissel, Henning Haase, Kathleen Laatz, Oliver S. Grosser

Abstract:

Concerning the inpatient care the present situation is characterized by intense charges of medical technology into the clinical daily routine and an ever stronger integration of special techniques into the clinical workflow. Medical technology is by now an integral part of health care according to consisting general accepted standards. Purchase and operation thereby represent an important economic position and both are subject of everyday optimisation attempts. For this purpose by now exists a huge number of tools which conduce more likely to a complexness of the problem by a comprehensive implementation. In this paper the advantages of an integrative information-workflow on the life-cycle-management in the region of medical technology are shown.

Keywords: Medical equipment maintenance, maintenanceworkflow, medical equipment management, optimisation ofworkflow.

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Authors: Nathan C. Lea, Tony Austin, Stephen Hailes, Dipak Kalra

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This paper introduces a tool that is being developed for the expression of information security policy controls that govern electronic healthcare records. By reference to published findings, the paper introduces the theory behind the use of knowledge management for automatic and consistent security policy assertion using the formalism called the Secutype; the development of the tool and functionality is discussed; some examples of Secutypes generated by the tool are provided; proposed integration with existing medical record systems is described. The paper is concluded with a section on further work and critique of the work achieved to date.

Keywords: Information Security Policy, Electronic Healthcare Records, Knowledge Management, Archetypes, Secutypes.

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Authors: K. Turhan, B. Kurt, E. Uzun

Abstract:

This paper describes Clinical Document Architecture Release Two (CDA R2) standard and a client application for messaging with SAĞLIK-NET project developed by The Ministry of Health of Turkey. CDA R2 , developed by Health Level 7 (HL7) organization and approved by American National Standards Institute (ANSI) in 2004, to standardize medical information to be able to share semantically and syntactically. In this study, a client application compatible with HL7 V3 for a project named SAĞLIKNET, aimed to build a National Health Information System by Turkey. Moreover, CDA conformance of this application will also be evaluated.

Keywords: HL7 V3, CDA, Interoperability, Web Service.

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Authors: Chin-Ming Hong, Chin-Teng Lin, Chao-Yen Huang, Yi-Ming Lin

Abstract:

In this article, we propose an Intelligent Medical Diagnostic System (IMDS) accessible through common web-based interface, to on-line perform initial screening for osteoporosis. The fundamental approaches which construct the proposed system are mainly based on the fuzzy-neural theory, which can exhibit superiority over other conventional technologies in many fields. In diagnosis process, users simply answer a series of directed questions to the system, and then they will immediately receive a list of results which represents the risk degrees of osteoporosis. According to clinical testing results, it is shown that the proposed system can provide the general public or even health care providers with a convenient, reliable, inexpensive approach to osteoporosis risk assessment.

Keywords: BMD, osteoporosis, IMDS, fuzzy-neural theory, web interface.

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Authors: Salama Meghriche, Amer Draa, Mohammed Boulemden

Abstract:

Heart failure is the most common reason of death nowadays, but if the medical help is given directly, the patient-s life may be saved in many cases. Numerous heart diseases can be detected by means of analyzing electrocardiograms (ECG). Artificial Neural Networks (ANN) are computer-based expert systems that have proved to be useful in pattern recognition tasks. ANN can be used in different phases of the decision-making process, from classification to diagnostic procedures. This work concentrates on a review followed by a novel method. The purpose of the review is to assess the evidence of healthcare benefits involving the application of artificial neural networks to the clinical functions of diagnosis, prognosis and survival analysis, in ECG signals. The developed method is based on a compound neural network (CNN), to classify ECGs as normal or carrying an AtrioVentricular heart Block (AVB). This method uses three different feed forward multilayer neural networks. A single output unit encodes the probability of AVB occurrences. A value between 0 and 0.1 is the desired output for a normal ECG; a value between 0.1 and 1 would infer an occurrence of an AVB. The results show that this compound network has a good performance in detecting AVBs, with a sensitivity of 90.7% and a specificity of 86.05%. The accuracy value is 87.9%.

Keywords: Artificial neural networks, Electrocardiogram(ECG), Feed forward multilayer neural network, Medical diagnosis, Pattern recognitionm, Signal processing.

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Authors: Fahad Shahbaz Khan, Fahad Maqbool, Saad Razzaq, Kashif Irfan, Tehseen Zia

Abstract:

Expert systems are used extensively in many domains. This paper discusses the use of medical expert systems in Pakistan. Countries all over the world pay special attention on health facilities. A country like Pakistan faces a lot of trouble in health sector. Several attempts have been made in Pakistan to improve the health conditions of the people but the situation is still not encouraging. There is a shortage of doctors and other trained personnel in Pakistan. Expert systems can play a vital role in such cases where the medical expert is not readily available. The purpose of this paper is to analyze the role that such systems can play in improving the health conditions of the people in Pakistan.

Keywords: Medical Diagnostics, Expert Systems, Pakistan.

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Authors: Giovanni Luca Masala

Abstract:

Pattern recognition is the research area of Artificial Intelligence that studies the operation and design of systems that recognize patterns in the data. Important application areas are image analysis, character recognition, fingerprint classification, speech analysis, DNA sequence identification, man and machine diagnostics, person identification and industrial inspection. The interest in improving the classification systems of data analysis is independent from the context of applications. In fact, in many studies it is often the case to have to recognize and to distinguish groups of various objects, which requires the need for valid instruments capable to perform this task. The objective of this article is to show several methodologies of Artificial Intelligence for data classification applied to biomedical patterns. In particular, this work deals with the realization of a Computer-Aided Detection system (CADe) that is able to assist the radiologist in identifying types of mammary tumor lesions. As an additional biomedical application of the classification systems, we present a study conducted on blood samples which shows how these methods may help to distinguish between carriers of Thalassemia (or Mediterranean Anaemia) and healthy subjects.

Keywords: Computer Aided Detection, mammary tumor, pattern recognition, thalassemia.

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Authors: Y. Y. Su, K. T. Win, H. C. Chiu

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This study used Item Analysis, Exploratory Factor Analysis (EFA) and Reliability Analysis (Cronbach-s α value) to exam the Questions which selected by the Delphi method based on the issue of “Socio-technical system (STS)" and user-centered perspective. A structure questionnaire with seventy-four questions which could be categorized into nine dimensions (healthcare environment, organization behaviour, system quality, medical data quality, service quality, safety quality, user usage, user satisfaction, and organization net benefits) was provided to evaluate EMR of the Taiwanese healthcare environment.

Keywords: Instrument development, Reliability test, Validity test, Electronic Medical Record Evaluation.

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Authors: Nevena Stolba, A Min Tjoa

Abstract:

Evidence-based medicine is a new direction in modern healthcare. Its task is to prevent, diagnose and medicate diseases using medical evidence. Medical data about a large patient population is analyzed to perform healthcare management and medical research. In order to obtain the best evidence for a given disease, external clinical expertise as well as internal clinical experience must be available to the healthcare practitioners at right time and in the right manner. External evidence-based knowledge can not be applied directly to the patient without adjusting it to the patient-s health condition. We propose a data warehouse based approach as a suitable solution for the integration of external evidence-based data sources into the existing clinical information system and data mining techniques for finding appropriate therapy for a given patient and a given disease. Through integration of data warehousing, OLAP and data mining techniques in the healthcare area, an easy to use decision support platform, which supports decision making process of care givers and clinical managers, is built. We present three case studies, which show, that a clinical data warehouse that facilitates evidence-based medicine is a reliable, powerful and user-friendly platform for strategic decision making, which has a great relevance for the practice and acceptance of evidence-based medicine.

Keywords: data mining, data warehousing, decision-support systems, evidence-based medicine.

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Authors: Chakkrit Snae, Michael Brueckner

Abstract:

In this paper the authors present the framework of a system for assisting users through counseling on personal health, the Personal Health Assistance Service Expert System (PHASES). Personal health assistance systems need Personal Health Records (PHR), which support wellness activities, improve the understanding of personal health issues, enable access to data from providers of health services, strengthen health promotion, and in the end improve the health of the population. This is especially important in societies where the health costs increase at a higher rate than the overall economy. The most important elements of a healthy lifestyle are related to food (such as balanced nutrition and diets), activities for body fitness (such as walking, sports, fitness programs), and other medical treatments (such as massage, prescriptions of drugs). The PHASES framework uses an ontology of food, which includes nutritional facts, an expert system keeping track of personal health data that are matched with medical treatments, and a comprehensive data transfer between patients and the system.

Keywords: Personal health assistance service, expert system, ontologies, knowledge management, information technology.

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Authors: Nevine M. Labib, Michael N. Malek

Abstract:

Data Mining aims at discovering knowledge out of data and presenting it in a form that is easily comprehensible to humans. One of the useful applications in Egypt is the Cancer management, especially the management of Acute Lymphoblastic Leukemia or ALL, which is the most common type of cancer in children. This paper discusses the process of designing a prototype that can help in the management of childhood ALL, which has a great significance in the health care field. Besides, it has a social impact on decreasing the rate of infection in children in Egypt. It also provides valubale information about the distribution and segmentation of ALL in Egypt, which may be linked to the possible risk factors. Undirected Knowledge Discovery is used since, in the case of this research project, there is no target field as the data provided is mainly subjective. This is done in order to quantify the subjective variables. Therefore, the computer will be asked to identify significant patterns in the provided medical data about ALL. This may be achieved through collecting the data necessary for the system, determimng the data mining technique to be used for the system, and choosing the most suitable implementation tool for the domain. The research makes use of a data mining tool, Clementine, so as to apply Decision Trees technique. We feed it with data extracted from real-life cases taken from specialized Cancer Institutes. Relevant medical cases details such as patient medical history and diagnosis are analyzed, classified, and clustered in order to improve the disease management.

Keywords: Data Mining, Decision Trees, Knowledge Discovery, Leukemia.

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Authors: F. Lievens, M. Jordanova

Abstract:

Telemedicine is brought to life by contemporary changes of our world and summarizes the entire range of services that are at the crossroad of traditional healthcare and information technology. It is believed that eHealth can help in solving critical issues of rising costs, care for ageing and housebound population, staff shortage. It is a feasible tool to provide routine as well as specialized health service as it has the potential to improve both the access to and the standard of care. eHealth is no more an optional choice. It has already made quite a way but it still remains a fantastic challenge for the future requiring cooperation and coordination at all possible levels. The strategic objectives of this paper are: 1. To start with an attempt to clarify the mass of terms used nowadays; 2. To answer the question “Who needs eHealth"; 3. To focus on the necessity of bridging telemedicine and medical (health) informatics as well as on the dual relationship between them; as well as 4. To underline the need of networking in understanding, developing and implementing eHealth.

Keywords: E-Health/telemedicine, networking, medical informatics.

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Authors: Åsa Smedberg

Abstract:

There are different kinds of online systems on the Internet for people who need support and develop new knowledge. Online communities and Ask the Expert systems are two such systems. In the health care area, the number of users of these systems has increased at a rapid pace. Interactions with medical trained experts take place online, and people with concerns about similar health problems come together to share experiences and advice. The systems are also used as storages and browsed for health information. Over the years, studies have been conducted of the usage of the different systems. However, in what ways the systems can be used together to enhance learning has not been explored. This paper presents results from a study of online health-communities and an Ask the Expert system for people who suffer from overweight. Differences and similarities in regards to posted issues and replies are discussed, and suggestions for a new holistic design of the two systems are presented.

Keywords: Learning, Ask the Expert, online community, healthcare, holistic, overweight.

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Authors: Giovanni Luca Masala

Abstract:

Pattern recognition is the research area of Artificial Intelligence that studies the operation and design of systems that recognize patterns in the data. Important application areas are image analysis, character recognition, fingerprint classification, speech analysis, DNA sequence identification, man and machine diagnostics, person identification and industrial inspection. The interest in improving the classification systems of data analysis is independent from the context of applications. In fact, in many studies it is often the case to have to recognize and to distinguish groups of various objects, which requires the need for valid instruments capable to perform this task. The objective of this article is to show several methodologies of Artificial Intelligence for data classification applied to biomedical patterns. In particular, this work deals with the realization of a Computer-Aided Detection system (CADe) that is able to assist the radiologist in identifying types of mammary tumor lesions. As an additional biomedical application of the classification systems, we present a study conducted on blood samples which shows how these methods may help to distinguish between carriers of Thalassemia (or Mediterranean Anaemia) and healthy subjects.

Keywords: Computer Aided Detection, mammary tumor, pattern recognition, dissimilarity

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