Biomedical informatics applications for epilepsy management: A systematic review

Epilepsy is a very complex disease which can have a variety of etiologies, co-morbidities, and a long list of psychosocial factors4. Clinical management of epilepsy patients typically includes serological tests, EEG's, and imaging studies to determine the single best antiepileptic drug (AED). Self-management is a vital component of achieving optimal health when living with a chronic disease. For patients with epilepsy self-management includes any necessary actions to control seizures and cope with any subsequent effects of the condition9; including aspects of treatment, seizure, and lifestyle. The use of computer-based applications can allow for more effective use of clinic visits and ultimately enhance the patient-provider relationship through focused discussion of determinants affecting self-management. ^ The purpose of this study is to conduct a systematic literature review on informatics application in epilepsy self-management in an effort to describe current evidence for informatics applications and decision support as an adjunct to successful clinical management of epilepsy. Each publication was analyzed for the type of study design utilized. ^ A total of 68 publications were included and categorized by the study design used, development stage, and clinical domain. Descriptive study designs comprised of three-fourths of the publications and indicate an underwhelming use of prospective studies. The vast majority of prospective studies also focused on clinician use to increase knowledge in treating patients with epilepsy. ^ Due to the chronic nature of epilepsy and the difficulty that both clinicians and patients can experience in managing epilepsy, more prospective studies are needed to evaluate applications that can effectively increase management activities. Within the last two decades of epilepsy research, management studies have employed the use of biomedical informatics applications. While the use of computer applications to manage epilepsy has increased, more progress is needed.^

Building a Open Source Framework for Virtual Medical Training

This paper presents a framework to build medical training applications by using virtual reality and a tool that helps the class instantiation of this framework. The main purpose is to make easier the building of virtual reality applications in the medical training area, considering systems to simulate biopsy exams and make available deformation, collision detection, and stereoscopy functionalities. The instantiation of the classes allows quick implementation of the tools for such a purpose, thus reducing errors and offering low cost due to the use of open source tools. Using the instantiation tool, the process of building applications is fast and easy. Therefore, computer programmers can obtain an initial application and adapt it to their needs. This tool allows the user to include, delete, and edit parameters in the functionalities chosen as well as storing these parameters for future use. In order to verify the efficiency of the framework, some case studies are presented.

Statistical methods for analysis and processing of medical ultrasound: applications to segmentation and restoration

In this thesis two major topics inherent with medical ultrasound images are addressed: deconvolution and segmentation. In the first case a deconvolution algorithm is described allowing statistically consistent maximum a posteriori estimates of the tissue reflectivity to be restored. These estimates are proven to provide a reliable source of information for achieving an accurate characterization of biological tissues through the ultrasound echo. The second topic involves the definition of a semi automatic algorithm for myocardium segmentation in 2D echocardiographic images. The results show that the proposed method can reduce inter- and intra observer variability in myocardial contours delineation and is feasible and accurate even on clinical data.

The application of medical informatics to the veterinary management programs at companion animal practices in Alberta, Canada: a case study.

Companion animals closely share their domestic environment with people and have the potential to, act as sources of zoonotic diseases. They also have the potential to be sentinels of infectious and noninfectious, diseases. With the exception of rabies, there has been minimal ongoing surveillance of, companion animals in Canada. We developed customized data extraction software, the University of, Calgary Data Extraction Program (UCDEP), to automatically extract and warehouse the electronic, medical records (EMR) from participating private veterinary practices to make them available for, disease surveillance and knowledge creation for evidence-based practice. It was not possible to build, generic data extraction software; the UCDEP required customization to meet the specific software, capabilities of the veterinary practices. The UCDEP, tailored to the participating veterinary practices', management software, was capable of extracting data from the EMR with greater than 99%, completeness and accuracy. The experiences of the people developing and using the UCDEP and the, quality of the extracted data were evaluated. The electronic medical record data stored in the data, warehouse may be a valuable resource for surveillance and evidence-based medical research.

e-MIR2: a public online inventory of medical informatics resources

Background. Over the last years, the number of available informatics resources in medicine has grown exponentially. While specific inventories of such resources have already begun to be developed for Bioinformatics (BI), comparable inventories are as yet not available for Medical Informatics (MI) field, so that locating and accessing them currently remains a hard and time-consuming task. Description. We have created a repository of MI resources from the scientific literature, providing free access to its contents through a web-based service. Relevant information describing the resources is automatically extracted from manuscripts published in top-ranked MI journals. We used a pattern matching approach to detect the resources? names and their main features. Detected resources are classified according to three different criteria: functionality, resource type and domain. To facilitate these tasks, we have built three different taxonomies by following a novel approach based on folksonomies and social tagging. We adopted the terminology most frequently used by MI researchers in their publications to create the concepts and hierarchical relationships belonging to the taxonomies. The classification algorithm identifies the categories associated to resources and annotates them accordingly. The database is then populated with this data after manual curation and validation. Conclusions. We have created an online repository of MI resources to assist researchers in locating and accessing the most suitable resources to perform specific tasks. The database contained 282 resources at the time of writing. We are continuing to expand the number of available resources by taking into account further publications as well as suggestions from users and resource developers.

p-medicine: a medical informatics platform for integrated large scale heterogeneous patient data

Secure access to patient data is becoming of increasing importance, as medical informatics grows in significance, to both assist with population health studies, and patient specific medicine in support of treatment. However, assembling the many different types of data emanating from the clinic is in itself a difficulty, and doing so across national borders compounds the problem. In this paper we present our solution: an easy to use distributed informatics platform embedding a state of the art data warehouse incorporating a secure pseudonymisation system protecting access to personal healthcare data. Using this system, a whole range of patient derived data, from genomics to imaging to clinical records, can be assembled and linked, and then connected with analytics tools that help us to understand the data. Research performed in this environment will have immediate clinical impact for personalised patient healthcare.

El nuevo sistema de información y gestión de salud ambiental (SIGSA) se pone en marcha en Andalucía con vocación integradora

Boletín semanal para profesionales sanitarios de la Secretaría General de Salud Pública y Participación Social de la Consejería de Salud

The sustainability of a Spanish Regional Virtual Library

Objectives: The Andalusian Health e-Library (BV-SSPA) is the National Health Library in the region of Andalusia (Spain). It is a corporate hospital library created in 2006. The year 2012 is a turning point for the Spanish economy, and the BV-SSPA has to demonstrate that it is cost-effective and sustainable. Methods: Andalusia is a wide Spanish region with more than 8 million inhabitants, more than 100,000 health professionals for 41 hospitals, 1,500 primary health care centers, and 28 centers for nonmedical attention purposes, and the BV-SSPA was created to cover all these health services. It was appointed the only intermediary for contracting electronic resources destined to the Andalusian Health System. Hospitals are not allowed to subscribe any resources, and the same services are offered for the whole system. Results: In 2011, the BV-SSPA reached the biggest electronic health sciences resource collection in Spain: a total amount of 2,431 subscribed titles, besides 8 databases and other scientific information resources. The following goals were also achieved: • Cost-effectiveness: In 2011, the BV-SSPA represented a saving percentage of 25.42% compared to the individual hospital subscription costs if they would have continued their contracting. • Efficiency: Central purchasing has meant for the Andalusian health professionals, the democracy of research resource access. Some services were also created: • integrated and safe remote access to all the library resources independent of the user’s location • citizenship website, where the resources for citizenship are grouped • Centralized Document Supply Service, focusing all the article orders from and for the Andalusian Health System • institutional repository, which contains the whole intellectual, scientific production generated by the Andalusian health professionals • computer application to study the Andalusian health system scientific production • Social media as instrument for communicating with users • science web, a defined space for researchers. Conclusions: Although Andalusia is facing a dreadful economic situation, the BV-SSPA has demonstrated its sustainability: • For 2012 renewals, it carried out a statistics study allowing obtaining enough data for deciding which titles were not being discharged by users. • Titles with no discharges or without impact factor were rejected after strong negotiation with suppliers, as the BV-SSPA after 6 years on, is considered a strong dealer by them. • This meant savings of 14% from the original budget for 2012, which allowed the continuity of the BV-SSPA without decreasing the quality offered to their users.

La gestión del conocimiento en Ciencias de la Salud en Andalucía: una estrategia viable

The Andalusian Health e-Library was set-up in 2006 as a government initiative of the region. After these seven years, its achievements have placed it as the knowledge manager of Health Sciences in Andalusia. It centralizes the subscription of information resources and the acquisition of applied technologies, but it also implements the necessary services for the research community in order to provide a better management of the information which is used and generated. Nowadays, in these economic turbulence days, the Digital Library optimizes the management and the economic resources in order to suit the Andalusian Government commitment in terms of assistance and research activities.

La gestión del conocimiento en Ciencias de la Salud en Andalucía: una estrategia viable

The Andalusian Health e-Library was set-up in 2006 as a government initiative of the region. After these seven years, its achievements have placed it as the knowledge manager of Health Sciences in Andalusia. It centralizes the subscription of information resources and the acquisition of applied technologies, but it also implements the necessary services for the research community in order to provide a better management of the information which is used and generated. Nowadays, in these economic turbulence days, the Digital Library optimizes the management and the economic resources in order to suit the Andalusian Government commitment in terms of assistance and research activities.

How to manage a virtual library?

Introduction. The Andalusian Public Health System Virtual Library (Biblioteca Virtual del Sistema Sanitario Público de Andalucía, BV-SSPA) was created in June 2006, after being determined by the II Quality Plan in the key process Guarantee the Knowledge Exchange into the Health System which was established by the Strategy IV, Knowledge Management, 2005-2008. It is a government strategy with its own budget and management with the aim of rationalizing the subscriptions into the Andalusian Health System and democratizing the health professional access to qualify scientific information, regardless of the professional workplace. Andalusia is a wide region with more than 8 million inhabitants, more than 90,000 health professionals for 41 hospitals, 1,500 primary healthcare centres, and 12 centres for non-medical attention purposes, and the Virtual Library was created to cover all this Health Services. Before the creation of the BV-SSPA every centre had its own budget and management decisions concerning scientific resources, with the creation of the BV-SSPA both management and budget were centralized. Objectives. With this work we pretend to analyze if the results after these five years have reached the expectations from an economic point of view and determine if really we can offer a benefit to the Andalusian Professional and Society in general. We will demonstrate the following: - The BV-SSPA supposed a cost reduction. It meant cost-effectiveness. - It resulted in Economics of Scale, as we have every year more resources and services investing a minor proportional amount of money. - In terms of Efficiency it implemented more services than the System had before its creation, we a lower budget. Methods. The BV-SSPA was appointed the only intermediary for contracting electronic resources destined to the Andalusian Health System. This had some consequences which should be analyzed: - Hospitals were not allowed to subscribe any resources. - Services offered for the whole System. - A remote access system was created. - Tools to give more visibility to the Public Health System were developed. - Negotiations techniques changed as the BV-SSPA is stronger than individual hospitals. Results. - The amount of 2,431 electronic reviews, 8 data bases and other scientific information resources at the disposal of the Andalusian Health System Professionals and available worldwide requiring only an internet connection. Before the BV-SSPA, 5,267 titles were subscribed by hospital and 2,967 of them were subscribed repeatedly (by two or more hospitals), this represented more than 55%. The rationalization of the subscription investment has been reached. - The establishment of several important scientific services for the whole territory of Andalusia, not only big hospitals. - The use of appropriate tools through a Web 2.0 and Social Media to be acknowledged by most National Health Professionals. Conclusions. It has been demonstrated that the BV-SSPA has become the Central Unit for purchasing, offering librarian services and a reference for users in terms of knowledge management, but from the point of view of business it has also obtained the following results: - Cost-Effectiveness: Its budget for subscriptions is lower than the hospital former one in a 30% and now more electronic resources are available. - Economics of Scale: Near 95,000 health professionals can access this Virtual Library in 2010. Before its creation Professionals for small hospital and Primary Care centres were not able to access to scientific information subscribed by big hospitals. - Efficiency Besides the central electronic purchasing, services were created for the System, without increasing the expenses: - Remote access to all the library resources independent of the user’s location. The BV-SSPA usage increased in a 147% in 2008, when it was installed. - The Document Supply Service implemented in 2009. - The Institutional Repository which contains the whole intellectual, scientific production generated by the Andalusian Public Health Professionals as a result of their healthcare, research or managing activity. - The creation of an application developed by the BV-SSPA to study the Andalusian Health System Scientific Production. - The visibility of the Andalusian Health System reached thanks to the BV-SSPA, through the numerous events in which it participates and organizes such as the 2nd. European National Digital Libraries of Health Conferences and the National Conference of Health Science Information and Documentation held in Cadiz in 2010; and its profile in social media where it can be contacted by citizens and health professionals all over the world. - Negotiation with electronic resource suppliers is much more advantageous as the BV-SSPA is stronger to deal with them thanks to its consolidated budget, its managing independence and its visibility.

Integración de la Biblioteca Virtual del Sistema Sanitario Público de Andalucía en la política científica de la Consejería de Salud y Bienestar Social

Capítulo incluido en parte III del Congreso: Indicadores cuantitativos y cualitativos para el análisis de la colaboración científica

Andalusian Health e-Library

The Andalusian Health e-Library (Biblioteca Virtual del Sistema Sanitario Público de Andalucía, BV-SSPA) set up in June 2006 allows health professionals to access the most prestigious resources to facilitate decisiontaking, healthcare, teaching and research activities. It is considered the undisputed medium for health research and clinical healthcare in Andalusia, being consolidated as the Health Knowledge Manager in the region.