Obtención automática de palabras clave en textos clínicos: una aplicación de procesamiento del lenguaje natural a datos masivos de sospecha diagnóstica en Chile / Automatic keyword retrieval from clinical texts: an application of natural language processing to massive data of Chilean suspected diagnosis

Background: Free-text imposes a challenge in health data analysis since the lack of structure makes the extraction and integration of information difficult, particularly in the case of massive data. An appropriate machine-interpretation of electronic health records in Chile can unleash knowledge contained in large volumes of clinical texts, expanding clinical management and national research capabilities. Aim: To illustrate the use of a weighted frequency algorithm to find keywords. This finding was carried out in the diagnostic suspicion field of the Chilean specialty consultation waiting list, for diseases not covered by the Chilean Explicit Health Guarantees plan. Material and Methods: The waiting lists for a first specialty consultation for the period 2008-2018 were obtained from 17 out of 29 Chilean health services, and total of 2,592,925 diagnostic suspicions were identified. A natural language processing technique called Term Frequency-Inverse Document Frequency was used for the retrieval of diagnostic suspicion keywords. Results: For each specialty, four key words with the highest weighted frequency were determined. Word clouds showing words weighted by their importance were created to obtain a visual representation. These are available at cimt.uchile.cl/lechile/. Conclusions: The algorithm allowed to summarize unstructured clinical free-text data, improving its usefulness and accessibility.

PACS Implementation Challenges in a Public Healthcare Institution: A South African Vendor Perspective / 대한의료정보학회지

OBJECTIVES: Conventional radiological processes have been replaced by digital images and information technology systems within South Africa and other developing countries. Picture Archiving and Communication Systems (PACS) technology offers many benefits to institutions, medical personnel and patients; however, the implementation of such systems can be a challenging task. It has been documented that South Africa has been using PACS for more than a decade in public hospitals with moderate success. The aim of this study was to identify and describe the PACS challenges endured by PACS vendors during implementation in the South African public healthcare sector. METHODS: This was achieved by engaging in a methodological approach that was qualitative in nature collecting data through semi structured interviews from 10 PACS experts/participants which were later analysed qualitatively. RESULTS: The findings show that PACS vendors have countless challenges, some of which include space, insufficient infrastructure, image storage capacity, system maturity and vendor related concerns. It was clear that the PACS experts readily offered contextually appropriate descriptions of their encounters during PACS implementations in South African public healthcare institutions. CONCLUSIONS: PACS vendors anticipate these challenges when facing a public healthcare institution and it is recommended that the hospital management and potential PACS stakeholders be made aware of these challenges to mitigate their effects and aid in a successful implementation.

QASF 2. 0 - Sistema de perguntas e respostas em doenças crônicas / QASF 2. 0 - Question-answering system on chronic diseases / QASF 2. 0 - Sistema de pregunta y respuesta en enfermedades crónicas

As doenças crônicas são um grave problema mundial de saúde pública. Elas são responsáveis por morbidez,mortalidade, incapacidade e baixa qualidade de vida. No Brasil, 72% das mortes são causadas por doenças crônicas, e no mundo esse valor é de 60%. Sabe-se que a atual produção científica mundial é vasta e as informações contidas nos artigos científicos podem ser úteis para o profissional da saúde. Porém, ler artigos científicos é uma tarefa que exige tempo e disposição. O objetivo deste artigo é apresentar a segunda versão do sistema de perguntas e respostas QASF para auxiliar os profissionais da saúde e outros usuários na busca rápida por informações, especificamente, em doenças crônicas. O processo de desenvolvimento do sistema baseou-se na construção de módulos de processamento de pergunta,de documentos e de resposta. Com o QASF, espera-se facilitar o acesso a informações.

Chronic diseases is a global public health problem. They are responsible for morbidity, mortality, disability andpoor quality of life. Chronic diseases cause 60% of deaths worldwide and 72% of deaths in Brazil. It is known that the current world scientific production is vast and the information contained in scientific papers can be useful for health professionals. However, the reading of scientific articles is a demanding and time-consuming task. This paper presents a question answering system to help health professionals quickly search for information about chronic diseases. The core of the question answering system includes the development of modules for processing questions, documents and answers. It is expected to support users that demand for quick information about chronic diseases. Precision rates between 50% and 60% were obtained.

Aplicativos móveis desenvolvidos para a área da saúde no Brasil: revisão integrativa da literatura / Mobile applications developed for the health sector in Brazil: an integrative literature review / Aplicaciones móviles desarrolladas para el sector de la salud en Brasil: revisión integradora de la literatura

A popularização dos celulares inteligentes, os smartphones, tem sido considerada por muitos a revolução tecnológica de maior impacto nos últimos tempos. Considerado um computador de bolso e com acesso a milhões de aplicativos, sua principal característica é a quebra da limitação da mobilidade, acompanhando o seu usuário 24 horas por dia em qualquer lugar. Essa qualidade é fundamental para auxiliar a assistência em saúde, uma vez que esses profissionais deslocam-se constantemente dentro das instituições em que trabalham. Este estudo objetivou identificar quais as pesquisas envolvendo tecnologia móvel aplicada à saúde que estão sendo desenvolvidas no Brasil. A metodologia empregada é do tipo revisão integrativa da literatura. A amostra final contou com 27 trabalhos. A análise dos resultados trouxe que a temática mais abordada no desenvolvimento de aplicativos móveis para a área de saúde foi a de apoio ao profissional. Quando analisado o foco desses aplicativos, viu-se que a área mais beneficiada pela pesquisa em computação móvel tem sido a multiprofissional. Concluiu-se, com a revisão, que é de suma importância o desenvolvimento de aplicativos móveis vinculados à pesquisa científica em saúde, pois seu conteúdo será analisado e testado por profissionais que conhecem as reais necessidades dos usuários finais.

The popularization of smartphones has been considered by many the technological revolution of greatest impact in recent years. Considered a pocket computer with access to millions of applications, its main feature is the breaking of the limitations of mobility, following its user 24 hours a day, anywhere. This quality is essential to assisting in healthcare activities, since these professionals constantly move around within the institutions in which they work. This study aimed to identify prior research developed in Brazil which involved mobile technology applied to healthcare. The methodology used in this study was an integrative literature review. The final sample included 27 articles. Analysis of results showed that the most commonly addressed theme in the production of mobile applications for the healthcare field was support for healthcare professionals. Analyzing the focus of mobile applications, it could be found that the category of interdisciplinarity was the most benefited by research in mobile technology. The review concluded that it is of great importance to develop mobile applications linked to scientific research on healthcare, since their content will be analyzed and tested by professionals who know the final users' real needs.

La popularización de los teléfonos inteligentes (smartphones) ha sido considerada por muchos como la revolución tecnológica de mayor impacto de los últimos tiempos. Se trata de un ordenador de bolsillo con acceso a millones de aplicaciones cuya principal característica es que la ruptura con los limites de la movilidad: puede seguir al usuario durante las 24 horas desde cualquier lugar. Esta cualidad es esencial para apoyar al sector de la salud ya que los profesionales se desplazan constantemente dentro de las instituciones dónde trabajan. El presente estudio ha buscado identificar los estudios que se están llevando a cabo en Brasil con tecnologia móvil aplicada a la salud. La metodologia utilizada es tipo revisión integradora de la literatura. La muestra final incluyó 27 estudios. El análisis de los resultados indica que el tema que más se desarrolla es el de apoyo profesional. Al analizar el foco de estas aplicaciones se observa que la zona más favorecida por la investigación en informática móvil es la multiprofesional. El artículo concluyó que es de suma importancia desarrollar aplicaciones móviles relacionadas con la investigación científica en salud porque su contenido podrá ser analizado y probado por profesionales que conocen las necesidades reales de los usuarios finales.

Use of a gesture user interface as a touchless image navigation system in dental surgery: Case series report

PURPOSE: The purposes of this study were to develop a workstation computer that allowed intraoperative touchless control of diagnostic and surgical images by a surgeon, and to report the preliminary experience with the use of the system in a series of cases in which dental surgery was performed. MATERIALS AND METHODS: A custom workstation with a new motion sensing input device (Leap Motion) was set up in order to use a natural user interface (NUI) to manipulate the imaging software by hand gestures. The system allowed intraoperative touchless control of the surgical images. RESULTS: For the first time in the literature, an NUI system was used for a pilot study during 11 dental surgery procedures including tooth extractions, dental implant placements, and guided bone regeneration. No complications were reported. The system performed very well and was very useful. CONCLUSION: The proposed system fulfilled the objective of providing touchless access and control of the system of images and a three-dimensional surgical plan, thus allowing the maintenance of sterile conditions. The interaction between surgical staff, under sterile conditions, and computer equipment has been a key issue. The solution with an NUI with touchless control of the images seems to be closer to an ideal. The cost of the sensor system is quite low; this could facilitate its incorporation into the practice of routine dental surgery. This technology has enormous potential in dental surgery and other healthcare specialties.

Medical informatics methods for the clinical evidence extraction

Clinical professionals gain new information to assist in patient care when they read the medical literature. Similarly, in clinical preventive medicine, medical science documents that have previously published can be searched and evaluated in order to confirm the scientific support for the clinical preventive medical service offered in order to prevent chronic disease. This paper introduces the medical informatics techniques for knowledge extraction that can become the basis for clinical practice. Particularly, it discusses the clinical document retrieval and knowledge discovery tools that can search for extracting the knowledge which the medical expert desires with data mining techniques. For example, Clinical medical personnel and medical researchers can locate the information from the latest literature rapidly or find and evaluate the scientific basis for the treatment and prevention of infection. This study can be used when they analyze the correlation between accumulated and different type of data and contributes to the detection of new knowledge. Recently, the concern about the visualization of massive data and information is high as the importance of big data has received greater attention. Contributions to this technique and decision support tools will increase gradually due to the way support for decision-making through scientific evidence for the pattern changing disease is evaluated or as one of the clinical practice guidelines is accepted.

Maniobra digital sobre el músculo dorsal ancho (m latissimus dorsi) para facilitar la disección axilar / Digital maneuver to the dorsal muscle wide (m latissmus dorsi) to facility the axillares dissection

Desde 1990 utilizamos durante la disección axilar en los casos de cáncer de mama, una maniobra que nos permite: identificar mejor la vena axilar en su porción externa, finalizar la disección del músculo dorsal ancho (m. latissimus dorsi), medir el grosor del tejido axilar a disecar y descartar la presencia del arco vascular de Lange, anomalía que puede presentarse en un 5 por ciento a 6 por ciento de los casos. Consideramos que este procedimiento ayuda a simplificar la disección axilar durante el acto quirúrgico. No hemos conseguido publicaciones que describan esta maniobra y hemos decidido hacer esta comunicación.

Since 1990 we used during axillaries dissection in cases of breast cancer, a maneuver that allows us; identify better the axillaries vein in the external portion, finalize the dissection of wide dorsal muscle (M. latissimus dorsi), measure the thickness of the axillary weaves to dissect and discard the presence of the vascular Lange arc, anomaly that can appear in 5 percent to 6 percent of the cases. We considered that this procedure helps to simplify the axillaries dissection during surgical act. We have not obtained publications that describe this maneuver and have decided to make this communication.

El aprendizaje computarizado estimula el pensamiento crítico / Computer-based learning stimulates critical thinking

Las computadoras han logrado accesos importantes a todos los aspectos de la medicina y se están utilizando cada vez más en la educación. Los beneficios incluyen disponibilidad constante, aprendizaje autograduado y uniformidad del currículum. También pueden ser utilizadas en localizaciones remotas por cualquiera que tenga acceso a Internet. Entre las ventajas más grandes de esta tecnología está el potencial de enseñar habilidades de pensamiento crítico a los estudiantes mediante el uso del aprendizaje basado en problemas (ABP). Una vez que se domina el pensamiento crítico, los proveedores pueden aplicarlo continuamente en el aprendizaje durante toda la carrera. Las computadoras pueden presentar una viñeta y múltiples usuarios pueden discutir asincrónicamente las soluciones clínicas. Si bien existen muchos enfoques publicados en relación con el autoaprendizaje en línea, muy pocos han sido evaluados críticamente en relación con su eficacia. Este manuscrito explora este potencial, describe en dónde nos encontramos actualmente y cómo podemos alcanzar el formato ideal de aprendizaje.

Computers have made significant inroads in every aspect of medicine and they are increasingly being used ineducation. Benefits include constant availability, selfpaced learning and uniformity of curriculum. They canalso be used in remote locations by anyone with internet access. Among the greatest advantages of this technologyis the potential to teach critical thinking skills to trainees using problem-based learning (PBL). Once critical thinkingskills are mastered, providers can then continually learn throughout their career. Computers can present a vignette and multiple users can asynchronously discuss clinical solutions. Although there are many published approaches regarding online self-learning, very few ofthese have been critically assessed regarding their effectiveness. This manuscript explores this potential,describes where we are today and how we can attain the ideal teaching format.

Estado actual de la informatización de los procesos de evaluación de medios de diagnóstico y análisis de decisión clínica / Current state of the informatization of the evaluation processes of diagnostic means and analysis of clinical decision

La creación de un programa informático para la evaluación de medios de diagnóstico y el análisis de decisión clínica demandó indagar detenidamente acerca de la situación actual con respecto a la automatización de ambos procesos, todo lo cual se expone sintetizadamente en este artículo, donde se plantea que el tratamiento computacional de estos métodos y procedimientos puede calificarse hoy como disperso e incompleto. Por la importancia y necesidad de disponer de un sistema automatizado y dadas las condiciones objetivas que propicia el actual desarrollo cientificotécnico, se aspira a lograr que el sistema desarrollado sea una herramienta novedosa, específica y potente.

The creation of a computer program for the evaluation of diagnostic means and the analysis of clinical decision demanded to investigate cautiously on the current situation in regard to the automation of both processes, all of which is briefly exposed in this article, where it is stated that the computer treatment of these methods and procedures can be qualified today as disperse and incomplete. Due to the importance and necessity of having an automated system and given the objective conditions that propitiates the current scientific and technical development, it is hoped that the developed system is a novel, specific and potent tool.

El módulo de computación en maestrías en Atención Primaria de Salud. Su impacto en la informatización de Matanzas / The computing module in the masteries in Primary Health Attention. Its impact in the informatization of Matanzas

A lo largo de más de cuatro décadas la Revolución Cubana ha creado un capital humano en el campo de la Salud y la base fundamental de las grandes transformaciones que en la actualidad se están llevando a cabo en el sector radica en el desarrollo científico de estos profesionales y técnicos, lograda por la política de educación permanente que ha ido conformando y diseñando un sistema para el control y seguimiento del nivel de actualización y del grado de competencia con que estamos enfrentando las acciones de salud y que ha tenido su máxima expresión en los últimos años en el desarrollo de diplomados como el de Genética, Emergencia y las maestrías para la Atención Primaria de Salud (APS). Estas Maestrías para la APS tienen un tronco común en el que se incluye la Computación, pues la aplicación de las Tecnologías de la Información y la Comunicación (TIC) se ha convertido en una imperiosa necesidad para aprovechar el potencial tecnológico en la gestión efectiva de la información y asegurar la formación de los recursos humanos necesarios. Se expone el impacto que en nuestro territorio ha tenido el desarrollo de la estrategia de Informatización trazada por el Departamento de Informática de la Facultad de Ciencias Médicas de Matanzas, se evidenció que un gran número de profesionales se preparó para la utilización e introducción de las TICs, los egresados del módulo perciben haber adquirido la preparación adecuada para integrarse a la sociedad de la información...

Throughout more than four decades of Cuban Revolution there has been created a human capital in the Health field, and the main base of the great transformations that are taking place nowadays in this sector is located in the scientific development of these professionals and technicians, reached through the politic of unending education that has being forming and designing a system to control and follow the actualization level and the level of competence with which we are affronting health actions, and that has have its highest expression during the last years in post-grade courses in Genetics, Emergency, and Masteries for Primary Health Care. These Masteries for Primary Health Care have a common trunk in which Computing is included because applying communication and information technologies has become an imperious necessity to take advantage of the technologic potential in the effective management of the information and, to assure the formation of the necessary human resources. We expose the impact have had in our territory the Informatization strategy, designed by the Department of Informatics of the Medical Sciences Faculty of Matanzas. It was evidenced that a great number of professionals was prepared to use and introduce the communication and information technologies. The graduated of the module perceive that they have acquired the adequate training to integrate themselves to the society of the information.

El aprendizaje visual: un aporte de la Informática, Telemedicina, Salud-e y Rede-s (TICs) a la educación / Visual learning: a contribution of the Technologies of Informatics and Communications to education

El desarrollo de la Informática, Telemedicina, Salud-e y Rede-s (TICs) ha proporcionado novedosos contextos de estudio caracterizados por su poder visual y creativo. Estos resultan particularmente efectivos en modelos pedagógicos tendientes a propiciar el aprendizaje autónomo como es el caso del modelo aplicado en la educación médica superior cubana a partir de la introducción del Policlínico Universitario. El método conocido como Aprendizaje Visual presupone la utilización de un conjunto de organizadores gráficos para ordenar información con el objetivo de apoyar al estudiante en la construcción del conocimiento mediante el trabajo con ideas y conceptos. La aplicación del Aprendizaje Visual como estrategia de aprendizaje propicia que el estudiante, mediante la representación gráfica de información e ideas, refuerce su comprensión, integre nuevo conocimiento (organizando, procesando y priorizando información nueva o ya conocida) e identifique conceptos erróneos. Para la implementación del Aprendizaje Visual existen diversas herramientas informáticas entre las que se encuentran: CmapTools, Inspiration, ConcepDraw MindMap, MindManager, Cronos y Macosoft. Se expone: el concepto de Aprendizaje Visual, la descripción de los organizadores gráficos más utilizados y su posible aplicación según los objetivos de aprendizaje, las características de la aplicación Inspiration y ejemplos de organizadores gráficos creados con fines didácticos utilizando la herramienta Inspiration.

Development of the Technologies of Informatics and Communications has provided contexts of study, characterized by their visual and creative power. They are particularly effective in pedagogical models directed to allow autonomous learning, as in the case of the model applied in Cuban High Medical Education since the introduction of the University Policlinics. The method, known as Visual Learning, presupposes using a whole of graphic organizers to order information with the objective of helping the student in building knowledge through working with ideas and concepts. Applying Visual Learning as a learning strategy propitiates that student, using the graphic representation of the information and ideas reinforces his comprehension, integrates new knowledge (organizing, processing and privileging new or already-known information), and identifies wrong concepts. To provide implements for Visual Learning there are several informatics tools as CmapTools, Inspiration, ConceptDraw MindMap, MindManager, Cronos y Macrosoft. We expose: the concept of Visual learning, the description of the most used graphic organizators and its possible aplication according to the learning objectives, the characteristics of Inspiration´s aplication and examples of graphic organizators with didactic purposes using the Inspiration tool.

Desenvolvimento de um software flexível no estudo de regeneração nervosa periférica / Development of flexible software for studying peripheral nerve regeneration

O estudo da recuperação de lesões nervosas periféricas do isquiático, fibular e tibial, obtidos através da análise motora, é considerado um bom critério de avaliação para a quantificação do grau de avaliação nervosa. O sistema de Análise Funcional dos Nervos Periféricos - AFNP que tem a funcionalidade da informatização deste processo, além de fornecer ao usuário uma maior agilidade na avaliação, permite ao pesquisador a utilização de um número maior de animais nos grupos experimentais, facilitando não só a captação, bem como o armazenamento e o processamento dos dados. A flexibilidade foi um resultado muito importante a ser ressaltado, pois mais de um usuário tem a possibilidade de interagir no sistema.

The study of the peripheral nerve regeneration after sciatic, fibular and tibial injuries, obtained through motion analysis, is regarded as a good evaluation criterion for quantifying the degree of nervous evaluation. The Functional Analysis of the Peripheral Nerves (AFNP) system that can transform this process into a computed one, not only provides the user with a higher evaluation agility, but also allows researchers to use a larger number of animals on experimental groups, facilitating the capture and data storage and processing, as well. Flexibility was a very important result to be highlighted, because more than one user is able to interact with the system.

Development of a System for Extracting the Information of Candidate Tumor Markers Reported in Biomedical Literatures / 대한진단검사의학회지

BACKGROUND: Since the human genome project was completed in 2003, there have been numerous reports on cancer and related markers. This study was aimed to develop a system to extract automatically information regarding the relationship between cancer and tumor markers from biomedical literatures. METHODS: Named entities of tumor markers were recognized by both a dictionary-based method and machine learning technology of the support vector machine. Named entities of cancers were recognized by the MeSH dictionary. RESULTS: Relational and filtering keywords were selected after annotating 160 abstracts from PubMed. Relational information was extracted only when one of the relational keywords was in an appropriate position along the parse tree of a sentence with both tumor marker and disease entities. The performance of the system developed in this study was evaluated with another set of 77 abstracts. With the relational and filtering keyword used in the system, precision was 94.38% and recall was 66.14%, while without the expert knowledge precision was 49.16% and recall was 69.29%. CONCLUSIONS: We developed a system that can extract relational information between a tumor and its markers by incorporating expert knowledge into the system. The system exploiting expert knowledge would serve as a reference when developing another information extraction system in various medical fields.

Consistent presentation of medical images based on CPI integration profile / 中国医疗器械杂志

Because of different display parameters and other factors, digital medical images present different display states in different section offices of a hospital. Based on CPI integration profile of IHE, this paper implements the consistent presentation of medical images, and it is helpful for doctors to carry out medical treatments of teamwork.

Nuevas herramientas para el desarrollo de la neuroanatomía computacional / New tools for the development of computational neuroanatomy

Se hizo una validación con un estudio preliminar de la variabilidad anatómica del cerebro, comparando las localizaciones de las estructuras corticales surco central y área medio temporal y la estructura subcortical glándula pineal en las imágenes de resonancia magnética nuclear de 4 sujetos sanos y las imágenes del cerebro de un fallecido, procesadas por la técnica de criosección. Se corroboró que la variabilidad de las estructuras corticales es mayor que las subcorticales y en el hemisferio izquierdo la variabilidad de la localización del área medio temporal es mayor significativamente, mientras que en el hemisferio derecho no. Se concluyó que los programas creados constituyen útiles herramientas para el desarrollo de la neuroanatomía computacional y estadística

La consulta de documentos digitalizados: una alternativa para los usuarios en la biblioteca de la facultad de estomatologia: experiencia de un año / Consultation on digitalized documents: an alternative for users in the Library of

La aplicación de las Nuevas Tecnologías de la Información y las Comunicaciones trae consigo cambios importantes en la labor de bibliotecas y centros de información, entre ellos se encuentra la transformación de los servicios existentes y la aparición de otros. En la Biblioteca de la Facultad de Estomatología el desarrollo de la Informática ha propiciado la creación de un Fondo de Publicaciones Electrónicas, con documentos científicos recuperados de Infomed, pertenecientes a revistas difíciles de adquirir por otras vías, lo cual constituye una alternativa para satisfacer las demandas en diferentes servicios y agilizar las respuestas. El propósito de este trabajo es describir las experiencias logradas con la creación de este fondo durante el período comprendido entre enero y diciembre de 2005. Para cumplimentar este objetivo, se determinaron las consultas realizadas al fondo de publicaciones electrónicas, por categorías de usuarios, las materias más solicitadas y representadas en el fondo, así como la procedencia de las fuentes donde se realizan las consultas

Tecnologias computacionais e ambientais virtuais no processo terapêutico de reabilitação / Computer Technologies and Virtual Environments in the Therapeutic Rehabilitation Process

Neste trabalho é apresentado um estudo sobre a utilização das tecnologias computacionais na área de reabilitação como meio auxiliar no processo terapêutico em diversas deficiências e incapacidade. Duas abordagens são apresentadas, uma utilizando os computadores no enfoque de educação de casos especiais e outra utilizando a tecnologia da realidade virtual por meio de ambientes virtuais. São apresentados exemplos mostrando que a tecnologia computacional tem sido utilizada como ferramenta auxiliar na reabilitação.