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MEDINFO92

Proceedings of the Seventh World Congress on Medical Informatics

Geneva Palexpo, Switzerland, 6-10 September 1992

K.C.LUNDivision of Biostatistics and Health Informatics

Department ofCommunity, Occupationaland FamilyMedicine

National Universityof Singapore, Singaporeand

World Health Organization Collaborating Centre for Health Informatics, Singapore

PATRICE DEGOULET THOMAS E. PIEMME OTTO RIEMHOFFMedical Informatics Department Office of Continuing Medical Education and Philipps University Marburg

Broussais University Hospital Department of Computer Medicine Division of Medical Informatics

Paris, France George Washington University Marburg, GermanyWashington, DC, U.S.A.

Parti

1992

NORTH-HOLLAND

AMSTERDAM LONDON • NEW YORK TOKYO

V

TABLE OF CONTENTS

Editorial xxxiForeword by the Chairman, MEDINFO 92 Scientific Programme Committee xxxiii

Message from the Chairman, MEDINFO 92 Organising Committee xxxix

MEDINFO 92 Committees xl

KEYNOTE ADDRESSES

What computers can and cannot do

Penrose, R xliii

The socio-cultural dimension of information technologiesElmandjra, Mahdi xlv

Improving communications at the desktopHopper, Andy xlix

Coming soon: Experimenting medical research with a virtual patientMagnenat-Thalmann N 1

PARTI

SECTION 1: COMPUTER SYSTEMS TECHNOLOGY

Section 1A: Software Systems Design and Assessment

"Locators", "Constructors" and "Trackers": Meta-level tools for supporting health care

professional information needs in a distributed computing milieu

Greenes RA(USA) 2

Improved maintenance of health information systems through reverse engineering

technologiesMiiller H A, Mohr J R and McDaniel J G (Canada) 9

Parallel computation for medicine and biology: Experience with LINDA

Sittig D F, Shifman M A, Nadkarni P and Miller P L (U.S A.) 14

Nominative object-oriented programming applications to interactive image analysis,

including symbolic processing.

Aurengo A, Hejblum G, Maksud P and Rica C (France) 20

Successful medical IS design using a metaparadigmKokol P, Stiglic B, Zumer V, Zorman A, Kancler K, Zavrsnik J and Bigec M(Czech and Slovak Federative Republic) * 25

Object-oriented design of a portable platform for medical image manipulation

Ligier Y, Funk M, Ratib O, Girard C, Perrier R and Snydr-Michal J (Switzerland) 26

The PRIST-2 Project on medical software engineering in a graphic user interface

environment

Cristiani P, Pazzi S and Stoppini A (Italy) * 33

* poster

vi

Surgery Unit Integrated Information System (SUII) project: Design and evaluation of

PC-based real-time monitoring stations using object-oriented programmingArseniev S B, Kiselev M V and Stekolnokov V V (Russia) 34

Section IB: Hardware Systems Design and Assessment

Medical informatics research at Georgia Tech: An overview

Ezquerra N F and Mullick R (U.SA.) *40

The integration of text, graphics and radiographic images on X-terminal

clinical workstations

London J W and Morton D E (U.SA.) 41

Use of bar coding on OR sutures in the University Hospital of Leiden

Schouten L and De Meijer P J J (The Netherlands)*

47

Smart cards for health care: Convergences and integration in hospital information systemBeuscart R, De Bournonville Ph, Paradinas P and Cornecq C (France) 48

Computer readable patient data cards: Design and Implementation

Pangalos G (Greece) *52

The impact of portable technology on health in developing countries: Recent progressand future potential

Byass P (United Kingdom) 53

Interfacing communication between the dentist and the computerNovelli M D (Brazil) 59

Impact of multimedia technology on medical information systemsDu Kweichiang (China) *

64

Section 1C: Network Communication Issues and Experience

Global networking: An important resource to basic research in the biomedical sciences

Tan T W (Singapore) 66

Metropolitan and wide-area collaboration in health care: The role of informatics conceptsand products

Beck J R, Ash J, Krages K P, Spackman K A, Prichard E L and Gorman P N (U.S.A.) 72

Health Link - A pragmatic approach to wide area telemedicine in CanadaMcDaniel J G, Mohr J R and Miiller H A (Canada) 78

Primary Health Orientated Computer Users' System: Overcoming the isolation of rural

doctors with computer based communication

Trumble S C, Cesnik B, Kidd M R, Connoley G and McPhee W J (Australia) 84

Feasibility of a regional EDI-network in Dutch Health Care

van Lierop D, Arnou P G, Hasman A and Ferwerda P H (The Netherlands) 89

Experiences with EDI in Dutch Health Care

Koens M L (The Netherlands) 94

A Dutch EDI project on hospital-supplier communicationLodder H, Koens M L and Belderebos D AA (The Netherlands) *

99

Implementation and diffusion of medical informatics: The case of electronic prescriptioncommunication between practitioners and pharmacies

Bernstein K and N0hr C (Denmark) *100

*poster

VII

An object-oriented message passing system for a client/server architecture

Tromp H and Hoffman G (Belgium) 101

Computer-supported cooperation of health care staff: The Peyas-Rekola case

Antti-Poika M and Korpela M (Finland) 106

An Integrated Academic Information Management System (IAIMS) at Georgetown University

BroeringNC(U.S.A.) 112

Achievements in Phase III of an Integrated Academic Information Management SystemJohnson S B, Clayton P D, Fink D J, Sengupta S, Shea S, Bourne P, Sideli R V,

Aguirre A, Cimino J J, Hripcsak G, McCormack M and Hill C (U.SA.) 117

A study of e-mail use on a health care electronic bulletin board

Kohli S, Moidu K, Farrier J, Chowdhury S I, Ahlfelt H, Wigertz Oand Trell E (Sweden/Canada)* 124

SECTION 2: DATABASE METHODS AND DELIVERY

Issues in relational database modelling and semantics for healthcare informatics

Canfield K (U.SA.) 126

An object-oriented approach towards integration of temporally-oriented medical data

and imagesPinciroli F, Combi C and Pozzi G (Italy) 131

Multi-facility integration: An approach to synchronized electronic medical records

in a decentralized health care systemCurtis AC (U.SA.) 138

The META-1* Engine: A database methodology used in building the UMLS® Metathesaurus®Sherertz D D, Olson N E, Tuttle M S, Sperzel W D, Erlbaum M S and Fuller L F (U.S.A.) 144

CARD III: Computerised audit and research database

Esuvaranathan K, Al-Hawamdeh S, Quek K M and Loke C (Singapore) 150

A multi-module haematological database for patient care and audit

Richards B, Evans C, Guo L S and Hyde K (United Kingdom) * 157

Computer-aided documentation in clinical gastroenteroIogy-GastroBaseKocna P, Kocna J and Fric P (Czech and Slovak Federative Republic)

* 158

Development of a database system for hypertensive intracerebral hemorrhage

Takahashi K, Kuroda S and Kanaya H (Japan) * 159

A database technology application for pharmaceutical industry information statistics

Li D J (China) 160

SECTION 3: HEALTH INFORMATION SYSTEMS

Section 3A: Design Concepts and Management Issues

The dynamics of a clinical information system

Blum B I (U.SA.) 168

* poster

viii

Design of a hospital information system: A comparison between interfaced and

integrated systemsBleich H L and Slack W V (U.SA.) 174

Barriers to clinical computing in American hospitalsSlack W V and Bleich H L (U.SA.) 178

Trends in modern hospital information systemsBakker A R (The Netherlands) 182

Towards a European framework reference model and architecture for the

development of open hospital information systemsvan der Werff A, Kilsdonk A, Damen W and Mensch H (The Netherlands/France) 188

The customisation of the RICHE HIS model: The role of knowledge servers

Riouall D, Frandji B, KanouiH and Catanese B (France) 194

Executive information from hospital information systemsMark J (Denmark) 199

Performance modelling study for a hospital information systemChen T S and Gough TG (Taiwan/United Kingdom) 204

The clinical information network: An archetype of data partnerships for evaluatingpatient's care

Schultz S and Elias A (U.SA.) 211

Experience with planning and designing an integrated hospital information systemPagonis D and Lacroix B (France)

*

217

Participative methods for the definition of the hospital information system of the

University Hospital in Lille

Beuscart R, Salomez J L, Nuttens M C, Pors A G and Purro N (France/Switzerland) * 218

Justification of clinical information systems: How to market informatics to hospitaladministration when resources are limited and scarce

GantzNJ(U.S.A.)* 219

The use of classical role delineation methodology in identifying job tasks and rolevariation of hospital chief information officers

Johns M L and DCosta A (U.SA.) *220

Requirements for an integrated, country-specific computer-aided prescription systemde Zegher I, Venot A, Milstein C, Berry D, Pizzutilo S, Mattatia V, Dahlberg Band Kostrewski B (Belgium/United Kingdom/Italy/France/Sweden) 221

Introducing HIS in Latin America: The case of Mexico

Espinosa A L (Mexico) *228

Section 3B: Systems for Hospital Wide Applications

The computer in a Nigerian teaching hospital: First-year experiencesDaini O A, Korpela M, Ojo J O and Soriyan H A (Nigeria/Finland) 230

A modern, fully-integrated hospital information systemMilan J and Munt C E (United Kingdom) 236

Development of a totally integrated hospital information system: An intelligenthospital at Osaka University

Takeda H, Matsumura Y, Kondo H, Imai K and Inoue M (Japan) 241

* poster

IX

A hospital communication system using international standards

Hergenroder G, Wentz B, Horbach L and Bell R K (Germany) *247

An integrated HIS structure: Coordination of the computer power of mainframes,workstations and personal computers

Honda M, Satomura Y, Yamazaki S, Amaral M B, Fujie A and Nagai H (Japan) * 248The development and evaluation of computer-generated alerts in an inpatient setting

Rind D M and Safran C (U.SA.) 249Total hospital information system using an optical disk filing system for medicalrecord management

Yamauchi K, Suzuki Y, Ikeda M and Miura T (Japan) 255

Cooperative data processing in an open HIS environment

Prokosch H U, Wieczorek D, Michel A and Dudeck J (Germany) 260

Object-oriented techniques in a hospital information systemDimitriu R and Popescu A (Romania) 266

Decentralized PAC system at Kyoto University HospitalMinato K, Komori M, Nakano Y and Takahashi T (Japan) 270

An image processing toolbox as a component of a ward information systemEngelmann U, Springub A, Dilo J, Scheppelmann D, Meinzer H P, Degoulet P,Jean F C, Jaulent M C, Scherrer J R, Baud R H, Coignard J and Lucas L

(Germany/France/Switzerland) 275A new computerized information-intensive and technical dispensing system

Ishikura C and Ishizuka H (Japan) 282

Integration of dermatological wards and laboratories into the Erlangen HospitalCommunication and Information System

Wentz B, Hergenroder G, Hergenroder E and Horbach L (Germany) *286

Migration onto distributed hospital information systemTarasow V V and Molchanow S M (Russia) *

287

Section 3C: Systems for Clinical Applications

The WELCOME project: Exhaustive analysis method and automatic encoding for clinical

care applicationsPolin E and Banifatemi A (France) 290

The SISIF Project: A pilot system for intensive care unit to approach completeintegration of data management

Heimendinger L, Jolliet P, Chevrolet J C, Schirato P, Sarrey E, Hochstrasser Dand Scherrer J R (Switzerland) 294

The computer as a communication tool between the emergency room and

the operating theatre

Vermeulen B J M, Borst F, Huber O, Trayser G, Unger P F, RohnerA and

Scherrer J R (Switzerland) 300

Development of an information system in the Emergency Department within a

global resource optimization projectCammelli L, Mazzuconi R, Lucchelli M and Zoppei G (Italy) * 304

Information system software engineering and training for the Operating Theatre

Ory C (France)*

305

*poster

X

PHARMNEPH:Computer assisted drug dosage adjustment in renal failure

Keller F, Erdmann K, Giehl M, Borner K and Biittner P (Germany) 306

Development of an anatomical pathology laboratory tracking systemMckeon P S, Essex Band Hall J (Australia) * 310

Diagnosis of ketonemia in children by neural network techniquesGarliauskas A and Garliauskiene A (Lithuania) * 311

Computer-assisted analysis of two dimensional polyacrylamide gel electrophoresisBurke P, Appel R D, Vargas R J, Alpay L L, Pellegrini C, Scherrer J R and

Hochstrasser D F (Switzerland) 312

Computer applications in psychiatric interviewingStarkweather J A (U.SA.)

* 318

Implementing a patient-based information system for the mental health service:

The importance of a staff focus

Robins S C and Rigby M J (United Kingdom) 319

Section 3D: Systems for Community-Based Applications

The epidemiologic surveillance of medical care using micro-computer technologyCaper P and Ostler D B (U.S.A.) 326

An information system for health monitoring in small areas

Dezelic Gj, Dezelic N, Hrastic-Novak L and Novak D (Croatia) 332

Computerized monitoring of epidemicsCarrat F, Garnerin Ph and Valleron A J (France) 338

A data processing system in epidemiological surveillance of communicable diseases

Martinez R, Aguirre A, Mesa A M, Mesa O L and Gallegos Z (Cuba) * 343

A home health care classification systemSaba V K and Zuckerman A E (U.SA.) 344

A study on a home care support information systemInada H, Horio H, Sekita Y, Ishikawa K and Yoshida M (Japan) 349

Computer-generated family oriented reminder letters

Hogg W E, Calonge N and Satenstein G (Canada/U.S.A.) 354

Health information system using optical memory cards: The Ishehara experienceHorie M, Ota Y, Ogushi Y, Suzuki S, Nomoto N, Nakamura M, Hinohara S and

Nakamura Y (Japan)On the design of an information/knowledge support for primary health care

Olchanski V (Russia)*

A new information system for pharmaco-epidemiology

Flory A, Verdier C and Eisinger F (France) *

Section 3E: Systems for Information Recording, Browsing and Retrieval

The Visible Human Project of the National Library of Medicine

Ackerman M J (U.S.A.)Issues in the development of an information retrieval system: The Physician'sInformation Assistant

Nelson S J, Sheretz D D and Tuttle M S (U.SA.)

* poster

XI

A desktop system for medical information retrieval: An application of

client-server techniquesWu G, Ahlfeldt H, Gill H and Wigertz O (Sweden) 376

COACH: An expert searcher program to assist Grateful Med®users searching MEDLINE

Kingsland L C III, Syed E J and Lindberg DAB (U.SA.) 382

From clinical literature to medical hypermedia:procedures and experiencesSjoberg C, Timpka T, Nyce J M, Peolsson M and af Klercker T (Sweden) 387

The Personal Health Summary - Capturing and using the Health Career:

A tool for clinicians, epidemiologists and managersGriewA R, Daniels D, Goldberg C B, James S D, Patterson R, Price D A,Savill A W, Taylor J E and Vincent D (United Kingdom) 393

Recording medical data in ELIAS: An inventorySollet P C G M, Duisterhout J S, van der Lei J and van Bemmel J H (The Netherlands) 399

A computer-based archive for true colour images in dermatologyBastian B C (Germany) 404

National substance abuse databases

Greberman S B, Montoya I D and Ball J C (U.SA.)* 408

A human brain atlas database

Fang T J, Ma L L, Wang Y X, Chen G, Xu J P, Wang Y H, Chen D C

and DneWL (China)* 409

Computer-aided cluster analysis of citation networks as a tool for research policyin biomedicine

Duplenko Y K and Burchinsky S G (Russia)* 410

SECTION 4: MEDICAL DECISION SUPPORT

Section 4A: Theory and Concepts

Combination of interpretations from different expertsKors J A and van Bemmel J H (The Netherlands) 412

Applications of connectionist systems in biomedicine

Sabbatini R M E (Brazil) 418

Lines and patterns of reasoning: New units of analysis for clinical decision making

Narayan S M, Corcoran-Perry S A and Turley J (USA) * 426

Challenges in disseminating a bayesian expert system: The French and German

versions of ILIAD

Bouhaddou O, Lepage E and Huber P (U.SA./France/Germany) 427

An object-oriented model of physicians' strategy at first encounters: An approach to sharing

distributed knowledge bases

Ohe K, Hishiki T, Koyama T and Kaihara S (Japan) 434

A knowledge acquisition framework for planning problems in health care:

A qualitative studyPetrucci K, Canfield K and Petrucci P (U.SA.) 440

Machine learning in medical domains: Some experiences of the KAVAS projectTalmon J L, Braspenning P, McNair P and Brender J (The Netherlands/Denmark) 447

* poster

xii

HIOS + : A decision aid in medicine

Dupuits F M H M and Hasman A (The Netherlands) 454

Medical application of fuzzy decision makingYoshida K, Ikeda S and Tazaki E (Japan) * 461

On object-orientedness in expert systems

Popper M, Stanek J and Hauskrecht M (Czech and Slovak Federative Republic) * 462

A conceptual model applied to medical knowledge databases and medical diagnosis by

expert systemsSotiropoulos M Th (Greece)

* 463

BADIA : An expert system shell based on bayesian inference techniquesBravo E and Delgado A (Cuba) * 464

Section 4B: Knowledge Representation and Databases

PENGUIN: An intelligent system for modelling and sharing declarative knowledge stored in

relational databases

Sujansky W, Zingmond D, Toshiyuki M and Barsalou T (U.S.A.) 466

Design and functions of medical knowledge editors for the Arden SyntaxGao X, Shahsavar N, Arkad K, Ahlfeldt H, Hripcsak G and WigertzO (Sweden/U.SA.) 472

Integrating clinical databases in a medical workstation using knowledge-based modellingTimmers T, van Mulligen E M and van den Heuvel F (The Netherlands) 478

Maintaining alternate interpretations of data from multiple sources in a clinical event

monitoring systemKohane I S (U.S.A.) 483

An expert system for AIDS patients management

Sobesky M, Le Beux P, Michelet C and Lenoir P (France) 490

The development of knowledge-based medical records for clinicians caring for patients with

HFV infection

Safran C, Rind D M, Herrmann F, Rury C, Caraballo E, Rippel K and KowaloffH (U.SA.) 495

Knowledge-based modelling for the classification and follow-up of patients with

congenital heart disease

van den Heuvel F, Timmers T, van Mulligen EM and Hess J (The Netherlands) 501

Extraction of temporal knowledge from patient records

Tsumoto S, Tanaka H and Satomura Y (Japan)* 506

The D-LOG language: Combining atomic elements to construct complex expressions in a

diagnostic consultation systemMuscari A (Italy) * 507

Prototypes as a core representation of medical knowledge in diagnosis and knowledge

acquisitionGierl L and Stengel-Rutkowski S (Germany) * 508

Knowledge modelling and the integration of medical decision trees

Hucklenbroich P (Germany)* 509

Learning from examples using extended generation trees with application to hemorheologyArunkumar S and Salunke M P (India)

* 510

poster

xia

Section 4C: Programs for Diagnosis and Clinical Care

The Quick Medical Reference (QMR) Relationships Function: Description and evaluation

of a simple, efficient "multiple diagnoses" algorithmMiller R A and Masarie F E Jr (U.S.A.) 512

A problem-solving model for protocol-based care: From e-ONCOCIN to EON

Musen M A, Tu S W and Shahar Y (U.SA.) 519

A decision support system using natural language processing and the DSM-IIIR

Amaral M B, Satomura Y, Honda M and Sato T (Brazil/Japan) 526

An integrated strategy of reasoning in a diagnostic decision system using natural languageprocessing and the DSM-IIIR

Amaral M B, Satomura Y, Honda M, Benedictis E M and Sato T (Brazil/Japan) * 531

Partner system "Consilium -1" as a tool for making decisions in medicine

Karp V P (Russia) *532

CHDDT: An expert system for congenital heart disease diagnosis and treatment

Zhong L and Jin P (China) 533

Computer-based monitoring and decision making in the diagnosis and therapy of

critically-ill patients after cardiac surgery

Ogrodowczyk H, Schmitt D, Friedel N, Hetzer R and Fleck E (Germany) * 538

A temporal model for long-term surveillance oftransplanted patientsLarizza C, Ferrari R and Stefanelli M (Italy) 539

Use of a hybrid expert system to predict wound infections

Hudson D L, Cohen M E and Lammers R K (U.SA.) 546

An expert system for postoperative care (POEMS)Sawar M J, Brennan T G, Cole A J and Stewart J (United Kingdom) 552

Knowledge-based interpretation of renal function, fluid and electrolyte metabolism

in intensive care

Schwaiger J, Haller M and Finsterer U (Germany) 558

SIMON: An integrated approach to patient monitoring in critical care environments

Uckun S, Dawant B M, Manders E J and Lindstrom D P (U.SA.) 564

ARRES: Computer-assisted decision support system for the post-Anaesthesia Care Unit

Ketikidis P H, Carson E R and Aukburg S J (Greece/United Kingdom/USA.) * 570

VOQUEL: A VOcal QUEry Language inside a user friendly interface in a complex expert

system for pancreatic diseases

Ferri F, Maceratini R, Rafanelli M and Sebastio A (Italy) 571

Some methods and problems of clinical testing of a model-based consultation

system for insulin therapyST- na S, Hovorka R and Haas T (Czechoslovakia)

* 578

Development project for an integrated expert system in the prognosis of chronic

liver disease

Bonfa I, Sarti F, Mazzoni G, Milandri G L, Maioli C and Dal Monte P R (Italy) 579

MAKEY: Automatic generation of a clinical algorithm for the serological diagnosis of

acute viral hepatitisDarmoni S J, Lebbe J, Vignes R and Poynard T (France) * 584

Development of a computerized knowledge based system integrated to a medical

workstation: Application to blood transfusion

Lepage E, Traineau R, Marchetti Ph, Benbunan M and Gardner RM (France/U.SA.) 585

* poster

xiv

A decision support system for diagnostic consultation in laboratory hematology

Nguyen D T, Diamond L W, Priolet G and Sultan C (France) 591

Leukaemia diagnosis: A challenging problem for an expert systemSmithA G and Gyde O H B (United Kingdom) 596

Computer-assisted bone marrow reporting: A novel use for an expert systemSmith A G and Gyde O H B (United Kingdom) * 602

Clinical assessment of the knowledge base of an expert system for data analysis in a

hematology laboratoryNishibori M, Nara N and Shiina S (Japan) * 603

Evaluation of the diagnostic encyclopedia workstation for ovarian pathologyvan Ginneken A M, Jansen W, Baak J P A, Smeulders A W M

and van der Lei J (Netherlands) 604

MEDICOTOX CONSILIUM: An expert system in clinical toxicologyMonov A, Iordanova I, Zagorchev P, Vassilev V, Nissimov M, Kojuharov R,Tconev R and Damianov V (Bulgaria) 610

ADINFER: Experience of an expert system in psychiatryOhayon M and Caulet M (Canada) 615

Computer-assisted geriatric patient assessment by physician extenders

WernerG and Smith ETS (U.SA.) 620

Decision support system on the multidimensional evaluation of the elderly

Sigulem D, Ancao M S, Lima O, Garcia J T, Toniolo J N, Ramos L R (Brazil) * 624

Diagnosing functional disorders of the cervical spine using backpropagation networks:

Preliminary results

Schoner W, Berger M, Holzmuller G, NeiB A and Ulmer H (Austria)* 625

The use of discriminant analysis and backpropagation networks to diagnose functional

disorders of the cervical spine after whiplash injuryUlmer H, Holzmuller G, Berger M and SchonerW (Austria) * 626

Section 4D: Programs for Image and Signal Analysis

Knowledge-based experimental design for planning biomedical image analysisGong L, Kulikowski CA and Mezrich R S (U.S.A.) 628

A-Map: A knowledge model of human brain atlas for CT interpretationYan Z, Eiho S and Tanaka H (Japan) 635

Computer-assisted CT reporting system using an ISAC image database

Ando Y, Ohya A, Tsukamoto N, Hashimoto S, Dokiya T, Iiyama K, Iwata T

and Karasawa H (Japan) *

Diagnosis of coronary artery disease with machine generated rules

Cios K J, Goodenday L S and Moraes I (U.SA.)Building an expert system for obtaining diagnoses from protein maps

Alpay L L, Appel R D and Hochstrasser D F (Switzerland)Neural networks for classification of EEG signals

Reddy D C and Korrai D R (India)A neutral network approach to assess myocardial infarction

Pazos A, Maojo V, Martin F and Ezquerra N F (Spain)

poster

XV

Section 4E: Programs for Management and Epidemiology

Development of ODESSA prototype on-line decision and executive support systemarchitecture for European healthcare management

Clough J, Herbage P, Hofdijk J, Morgan A and Orr S (U.K./Netherlands) * 666

An expert system for the scheduling of hospital beds

Ong L S, Lim T S and Chin W (Singapore) 667

A functional-link net approach to paediatric interhospital transport mode determination

Yamashita T S, Hosseini-Nezhad S M and Krug S E (U.SA.) * 672

Decision analysis in gastrointestinal cancer surveillance

Provenzale D, Wong J B, Kemp J A and Arora S (U.S.A.) 673

Pedigree analysis for genetic counselingSzolovits P and Pauker S P (U.SA.) 679

SECTION 5: MEDICAL RECORD SYSTEMS

Section 5A: Concepts and Designs

Technologies for computer-based patient records

Collen M F and Ball M J (U.SA.) 686

Using object-oriented design for medical records

Regan B (Australia) 691

New functional requirements for electronic medical records

Boon W M, Duisterhout J S, van Ginneken A M (The Netherlands) 697

Beyond UMLS: Computational semantics for medical records

Gangemi A, Galanti M, Galeazzi E and Rossi Mori A (Italy) 703

Theory and trials of computerized medical records: Metathesauri are coming, are you ready?Pakarinen V (Finland) * 709

Advanced card technology for an open health record systemMohr J R, McDaniel J G. Lezotte D and Miiller H A (Canada/U.SA.) 710

Recording information round the patient: moving towards a vision

Rigby M J (United Kingdom) 716

Section 5B: Experience with Medical Record Systems

Steps in implementing a multi-user integrated electronic medical record

Naeymi-Rad F, Trace D, Carmony L, Evens M, De Souza Almeida F,

Kepic T, Roberts R, Zelanski R, Juang M and Weil M H (U.SA.) 724

TMR - A profile of an electronic patient record

Hammond W E (U.SA.) 730

First co-operative experience with the computerized medical record system, SYLVICS

Jeanty C, Muller C and Hertoghe A (Belgium) 737

An electronic medical record system for a hospital information system

Yamashita Y, Yamamoto K, Sudo M, Okada Y, Nagata M and Takahashi T (Japan) 741

* poster

XVI

An electronic patient record combining free text and coded nomenclature:

Application to nursing process

Assimacopoulos A and Borgazzi A (Switzerland) 746

A fully-interative, fully-coded medical record for the paediatrician: Towards a source of

medical knowledge originating from the practitionerBorst F, Bolens M and Scherrer J R (Switzerland) 751

Management of graphic daily reports, clinical treatment and tests as part of a

computerised clinical records projectSarti F, Guazzotti L, Milandri G L, Giuliani Piccari G and Dal Monte P R (Italy) * 755

An automatic surveillance of genetic risk in primary care by linkage of routinely-used

individual patients records

van Damme J (Belgium) 756

SECTION 6: IMAGE AND SIGNAL ANALYSIS

Section 6A: Methods for Images and Patterns

Overview of JPEG: Is it acceptable in medical fields?

Kajiwara K (Japan)Multimodal segmentation of medical images

Schafer M, Scheppelmann D, Springub A, Engelmann U and Meinzer H P (Germany)Human perception and 3D visualization

Meinzer H P, Baur H J, Dilo J, Engelmann U, Meetz K, Schafer M, Scheppelmann D,

Springub A, Wolf Th (Germany)Distributed image management and hierarchical storage in an integrated RIS and PACS

Ratib O, Lemke H, Trayser G, Vurlod J F, Do H and Scherrer J R (Switzerland/Germany)Three-dimensional dynamic imaging of the spine

Brunie L and Lavallee S (France)A compact system for quantitative cardiovascular angiography analysis

Gronenschild E and Janssen J (The Netherlands)3D determination of the intravascular volume and flow of coronary arteries

Guggenheim N, Dorsaz P A, Doriot P A, Suilen C, Chappuis F

and Rutishauser W (Switzerland)An image storage and data processing system for hemodynamic-echocardiographic study

Piva R M V, Moura L A, MoraesA V, Bellotti G and Melo C P (Brazil)Implementation of a low-cost computer system for mitral regurgitation assessment in

contrast 2D echocardiograms

Zhang S, Marques de Sa J P, Guerreiro M and Abreu-Lima C (Portugal)Image processing automation of fibre autoradiograms

Beldishevski M O, Nergadze S G, Khachapuridze G C and Brelidze Z L (Rep. of Georgia)Image processing and classification methods to detect leukaemias

Serbouti S, Harms H, Duhamel A, Gunzer U, Beuscart R & Mary J Y (France/Germany) *

Use of quantitative image analysis and microdensitometry in immunohistochemistryBouras C, Vallet P G and Hof R P (Switzerland/U.S.A.) *

Accurate and fast classification of cancer cells by imagingMa S X, Kan X, Ye C Q, Gu B, Pan L, Zao W D and Zhang H X (China)

*

poster

xvii

Section 6B: Methods for Signal Processing and Analysis

Computer based analysis of cardiocirculatory and respiratory parameters after orthotopicheart transplantation: Methodological aspects and preliminary results

Litscher G, Schwarz G, Tscheliessnigg K H, Pfurtscheller G, Lechner A

and ListW F (Austria)Computerized dynamic electrocardiography with standardized psychic load: New

possibilites for preventive cardiologyMichel J, Cammann H, Uhlmann G, Orlov V, Petzschmann S and Linss G (Germany)

Time warping of the cardiac cycle in the ECG signal: Evaluation of beat-to-beat changesBaselli G, Porta A and Oneda F (Italy)

Methods and applications of continuous and. simultaneous EEG and evoked potentialmonitoring

Maresch H, Litscher G and Pfurtscheller G (Austria)Influences of the recognition artefact in long term electrocardiograms on time-domain

measurement of heart rate variabilityMalik M, Xia R, Poloniecki J, Odemuyiwa O, Farrell T, Staunton A &CammA J (U.K.) *

Prediction of future myocardial infarction from automated serial ECG analysis

Michaelis J, Lippold R, Nafe B and Scheidt E (Germany)

Processing of orthogonal ECG

Bacharova" L, Melotova J and Ruttkay-Nedecky I (Czech and Slovak Federative Republic)

PART 2

SECTION 7: STATISTICAL TECHNIQUES AND MODELLING

Section 7A: Statistical Techniques

Achieving standardization to support data pooling

Redekop W K, Studney D R, Farquhar R E and Paty D W (Canada) 860

Visualizing relationships in quantitative data sets: The computer-generated

permutation matrix

Schmid C and Hinterberger H (Switzerland) 866

Linking a patient's admissions and outpatient visits to form a "period of care"

Olsen P S (Denmark) 872

Real-time exploration of routinely collected data: An analysis of admissions for AIDS

in a teaching hospitalHerrmann F R and Safran C (U.SA.) 878

Clinical research using pooled data: The North American multiple sclerosis system

Studney D R, Thorne M, Redekop W K and Paty D W (Canada) 883

Testing the proportional hazards hypothesis on a tonsillar carcinoma data set:

A comparison of methods

Chale J J, Quantin C, Mosseri V, Asselain B, Moreau T and Dusserre L (France) 890

* poster