Abstract: A decision maker was presented with three states of health, such that an imaginary patient was in the middle state while the two other states could be described as more preferred and less preferred. The decision maker was then asked to choose the minimal odds at which he would advise an operation which would result in success, the patient moving into the more preferred state, or failure, the patient moving into the less preferred state. Eight decision makers were tested in this way and each made 24 such wagers on a set of three states chosen from a total set of eight; each of these states differed unidimen sionally only in the visual acuity of the remaining eye in the imaginary patient. If the utility of I is arbitrarily assigned to the state of perfect vision, and the utility of 0 to the state of non-perception of light, estimates of the utilities of the intervening states can then be made. The utility function for each decision maker was constructed and was found to be linear against the logarithm of the visual acuity. From this it follows that if all decision makers, e.g. ophthalmic surgeons, show such linearity, they will all choose the same odds before deciding whether to operate and these odds are independent of the utilities which the individual decision maker attaches to the different states of health.

Abstract: The paper deals with the present situation of education at the academic level in Medical Informatics (or Medical Information Science, Electronic Data Processing applied to medicine and the health care service etc.) in the Federal Republic of Germany. Following some introductory remarks about definitions, tasks, and prospects, the different types of education and their availability at certain universities are described. The current capacity is about 100 graduations per year. It is estimated by the author that in future the average number of positions to be occupied by medical computer scientists will be in the order of 50 per year for the Federal Republic of Germany including Berlin (West). It is, therefore, concluded that the present capacity in regard to graduations is sufficient. More emphasis should be laid on developing and organizing curricula for further qualification as well as refresher courses for those already engaged in the field of medical informatics.

Abstract: Computer-assisted diagnosis of dyspepsia-report on transferability of a system, with emphasis on early diagnosis of gastric cancer. -

Abstract: A suggestion for an effective use of a computer-aided diagnosis system in screening for hyperthyroidism. -

Abstract: An automated method for coding hospital patient records is described, which uses a combination of simple computer programs and a structured dictionary. The system accepts unrestricted medical language in French as input, and generates code combinations which represent the semantic values of the original statements. The coding structure is the trial version of the Systematized Nomenclature of Medicine (SNOMED) [9], A prototype system has been developed from a 20,000 word corpus of obstetrical and gynecological data, recorded from patient records written by French-speaking Quebec physicians. Preliminary test results on a small sample show that the system generates accurate codes and code combinations for 97.9% of the data tested. The programs were written in Fortran IV and implemented on a DEC PDP-9 computer. The dictionary keys are word segments and the entries contain operators, word segments and SNOMED codes. The dictionary structure permits a single entry to generate multiple SNOMED codes and to handle the types of linguistic paraphrase found in hospital records. The SNOMED codes and code combinations constitute a metalanguage which provides the means for data compression and uniform representation of natural language medical data.

Abstract: The Westinghouse Voice Response System is a stand-alone hardware unit designed for automated data collection. Questions are asked in the audio mode. Responses are printed at the time of the interview and stored on magnetic tape for future retrieval. This audio system was evaluated as a method for the collection of the initial medical history. In addition, comparisons were made among three techniques of automated data collection: audio, video and paper and pencil. The audio mode of automated history taking was more effective than comparable paper and pencil and video systems in situations where the patient population was of borderline literacy. The Westinghouse Voice Response System is a viable stand-alone system for those situations in which on-line access to a computer is not available.

Abstract: Expansion of a computerized obstetric medical record to include newborn nursery information is described. Data sheets are entered for each infant discharged, and a computer-typed discharge summary is generated which abstracts information originally gathered by both obstetric and pediatric medical personnel. The system has improved communication with medical providers who administer follow-up care after discharge and has replaced some physician dictation effort, especially in the Full Term Nursery. In the Intensive Care Nursery the summary has not been successful because data collected is not felt adequate to describe the chronology of a long hospitalization. Comparison of the computer record and manual discharge diagnosis sheet is presented.

Abstract: The results of an experiment to measure the performance of the Davidson and Soundex phonetic key compression schemes in finding sets of records representing the same individual in a moderately large radiology patient file, as compared to exact surname matches, are presented. This is similar to the problem of retrieving a record by name under the assumption that neither the search key nor the recorded key is accurately known. Both phonetic schemes perform similarly in obtaining extra matches and both outperform by a large margin the exact, name match. The results also indicate that the Davidson scheme is superior to the Soundex because it produces significantly fewer mismatches.

Abstract: Two examples of active health hazard monitoring systems are compared and contrasted, namely the World Health Organization’s Research Centre for International Monitoring of Adverse Reactions to Drugs which monitors side-effects of therapeutic drugs, and the »Programma de Investigaciön de Modelos de Prestaciön de Servicios de Salud« (PRIMOPS) which operates in Cali, Colombia, and monitors the activities, services and coverage of a community health system and its impact on the health of the community. These are just two examples of rapidly proliferating monitoring systems in which reports on adverse events are being submitted to a central clearing house by a network of reporting stations. It is shown how a Centre-Batch matrix constructed from the information contained in these reports can be analyzed to extract from it latent patterns. The detection of such patterns generates a warning signal, which in turn provides the incentive for further investigative action to be undertaken. These studies open up other areas of research, including the identification of the philosophical relationships between suspicion, evidence, statistical inference and action.

Abstract: Thesaurus der Medizin (TdM)--an internationally compatible diagnostic system of medicine. -

Abstract: The effect of contents page format on the efficiency and ease of scanning by 54 medical scientists, was tested using 14 different format patterns. Significant differences were found between formats with respect to speed of scanning, rate of missed key words, and subjective appeal to the reader. These three criteria were not necessarily related, but some formats were better than others in all three. The results seem to indicate that when the material directly related to the immediate purpose of the scanner is separated from unrelated material, such as in a separate column, and when the unrelated material is more concentrated spatially, efficiency of scanning is increased. Study of newly devised formats may lead to an optimal one with considerable gain in total scanning time and rate of key words located, as well as reduction in fatigue.

Abstract: Computer management of medical records, external consultations and archives in a gastro-enterology department. -

Abstract: Es wird ein Computerprogramm in der Sprache >SIMULA< vorgestellt, das zur laufenden Überwachung der Werte des carcinoembryonalen Antigens (CEA) in Seren von Patienten mit Adenokarzinomen des Gastrointestinaltrakts entwickelt wurde. Das Programm zeichnet individuelle Diagramme mit CEA-Verlaufskurven, die Prognosen hinsichtlich Metastasierung und Rezidivierung erlauben. Ferner erstellt das Programm Patientenstatistiken, Spezifikationslisten sowie individuelle Krankenblätter mid übernimmt die briefliche Einbestellung von Patienten zu Routineuntersuchungen im 2-Monatsabstand bzw. bei rasch steigendem CEA-Wert die sofortige Wiedereinbestellung. Das Programm erlaubt die Überwachung einer großen Zahl von Patienten und eignet sich auch für andere Überwachungsaufgaben mit einem oder mehreren Meßparametern.

Abstract: DARR: a free-text analysis system for the automatic documentation of radiological reports. -

Abstract: Die Vorteile der Zerlegung von Komposita bei der Klartextanalyse werden dargestellt. Dazu werden verschiedene Wortmodelle erlautert. Fur ein Wortmodell, bei dem ein Wort interpretiert wird als Folge von Wortteilen aus drei Typen von Segmenten, wird eine Sprache definiert, die eine formale komprimierte Notation der Regeln fur die Wortanalyse erlaubt. Die Implementierung des Verfahrens wird mit einer Beschreibung der Lexika und des Wortsegmentierungsalgorithmus vorgestellt.

Abstract: Key items of the source medical record are valuable in computing, notably when presented in a wellordered summary. These designations are preferred to complete coverage and narration. The computer file includes patient identification, reasons for the consultation, findings, treatment, outcome and successive episodes and/or observations; academic diagnoses are desirable if/when proved. Descriptors or nouns and qualifiers or adjectives constitute the computer vocabulary for key items, e.g., paincliest-precordium-sudden-severe-radiation-chin, ECG inverted T wave. Random numbers are useful to attain maximum simplicity and specificity of the input for filing, handling, timely communication and subsequent classification.

Abstract: The contribution of a special library project to a computerized problem-oriented medical information system (PROMIS) is discussed. Medical information displays developed by the PROMIS medical staff are accessible to the health care provider via touch screen cathode terminals. Under PROMIS, members of the library project developed two information services, one concerned with the initial building of the medical displays and the other with the updating of this information. Information from 88 medical journals is disseminated to physicians involved in the building of the medical displays. Articles meeting predetermined selection criteria are abstracted and the abstracts are made available by direct selective dissemination or via a problem-oriented abstract file. The updating service involves comparing the information contained in the selected articles with the computerized medical displays on the given topic. Discrepancies are brought to the attention of PROMIS medical staff members who evaluate the information and make appropriate changes in the displays. Thus a feedback loop is maintained which assures the completeness, accuracy, and currency of the computerized medical information. The development of this library project and its interface with the computerized health care system thus attempts to deal with the problems in the generation, validation, dissemination, and application of medical literature.

Abstract: One method for the systematic evaluation of adverse drug experience data within a pharmaceutical firm. -

Abstract: Die Anwendung der Netzwerktechnik zur Analyse von Untersuchungsablaufen in einem medizinischen Untersuchungszentrum wird beschrieben. Das behandelte Problem stellte sich im Rahmen einer EDVEinsatzplanung fur dieses Untersuchungszentrum. Im vorliegenden Anwendungsbeispiel ▪wird, im Gegensatz zur herkommlichen Praxis, die Netzwerktechnik dazu verwendet, ein bereits bestehendes System im zeitlichen und organisatorischen Ablauf nachzubilden. Durch Variation der Eingabedaten in einem Netzwerk-Rechnerprogramm werden Istund EDV-Sollzustand der medizinischen und verwaltungstechnischen Ablauforganisation erfast. Eine Gegenuberstellung der kritischen Wege im Netzwerk sowie der einzelnen Zeittabellen liefert Aussagen uber den zeitlichen Einflus von zukunftigen ED V-Masnahmen im vorgegebenen medizinischen System.

Abstract: The entire field of information processing in medicine is today already spread out and branched to such an extent that it is no longer possible to set up a survey on relevant literature as a whole. But even in narrow parts of medical informatics it is hardly possible for the individual scientist to keep up to date with new literature. Strictly defined special bibliographies on certain topics are most helpful. In our days, problems of optimal patient scheduling and exploitation of resources are gaining more and more importance. Scientists are working on the solution of these problems in many places. The bibliography on »Patient Scheduling« presented here contains but a few basic theoretical papers on the problem of waiting queues which are of importance in the area of medical care. Most of the papers cited are concerned with practical approaches to a solution and describe current systems in medicine. In listing the literature, we were assisted by Mrs. Wieland, Mr. Dusberger and Mr. Henn, in data acquisition and computer handling by Mrs. Gies and Mr. Schlaefer. We wish to thank all those mentioned for their assistance.

Abstract: On the indication for the use of the Pratt signed rank test -- demonstrated by an example -

Abstract: In the field of hospital care there lias been cooperation between various European hospital institutes in the last few years. Since 1970, a working party for information and documentation has been in operation, which was institutionalized as a Study Committee of the International Hospital Federation in 1973. A survey of this Study Committee showed a large degree of parallel and multiple work being done in the European documentation centers for hospital care. With a view to avoiding this duplication of work, a sensible division of labour has been initiated since 1968 by the Institute for Hospital Building of the Technical University of Berlin and the German Hospital Institute — an institute affiliated to the University of Düsseldorf. Thereby the national hospital literature is being indexed in the individual countries, but centrally collected, suitable for EDP. A magnetic tape service and an on-line access to a data bank in Düsseldorf are offered to the hospital institutes concerned. Within the framework of the network system, the original literature cited is made available to the partners on microfiche. For official institutionalization of the documentation network, an organizational concept has been developed, termed HECLINET (.Health Care. Literature information JVeiwork), which is at present being discussed with all the institutions concerned.