[Completeness assessment of the Breton registry of congenital abnormalities: A checking tool based on hospital discharge data]. / Contrôle automatisé de l'exhaustivité du registre breton des malformations congénitales à partir des données des bases médico-administratives des établissements de santé.

BACKGROUND: Exhaustiveness is required for registries. In the Breton registry of congenital abnormalities, cases are recorded at the source. We use hospital discharge data in order to verify the completeness of the registry. In this paper, we present a computerized tool for completeness assessment applied to the Breton registry. METHODS: All the medical information departments were solicited once a year, asking for infant medical stays for newborns alive at one year old and for mother's stays if not. Files were transmitted by secure messaging and data were processed on a secure server. An identity-matching algorithm was applied and a similarity score calculated. When the record was not linked automatically or manually, the medical record had to be consulted. The exhaustiveness rate was assessed using the capture recapture method and the proportion of cases matched manually was used to assess the identity matching algorithm. RESULTS: The computerized tool bas been used in common practice since June 2012 by the registry investigators. The results presented concerned the years 2011 and 2012. There were 470 potential cases identified from the hospital discharge data in 2011 and 538 in 2012, 35 new cases were detected in 2011 (32 children born alive and 3 stillborn), and 33 in 2012 (children born alive). There were respectively 85 and 137 false-positive cases. The theorical exhaustiveness rate reached 91% for both years. The rate of exact matching amounted to 68%; 6% of the potential cases were linked manually. CONCLUSION: Hospital discharge databases contribute to the quality of the registry even though reports are made at the source. The implemented tool facilitates the investigator's work. In the future, use of the national identifying number, when allowed, should facilitate linkage between registry data and hospital discharge data.

Big data and smart health strategies: findings from the health information systems perspective.

OBJECTIVES: To summarize excellent current research in the field of Health Information Systems. METHOD: Creation of a synopsis of the articles selected for the 2014 edition of the IMIA Yearbook. RESULTS: Four papers from international peer reviewed journals were selected and are summarized. CONCLUSIONS: Selected articles illustrate current research regarding the impact and the evaluation of health information technology and the latest developments in health information exchange.

Health Information Systems. Toward Evidence-based Health Information Systems?

OBJECTIVES: Summarize excellent current research in the field of Health Information Systems. METHOD: Synopsis of the articles selected for the IMIA Yearbook 2013. RESULTS: Five papers from international peer reviewed journals have been selected for the section on health information systems. CONCLUSIONS: The selected articles illustrate current research regarding health information technology (IT) impacts and evaluation and the latest developments in health information exchange.

Quality-evaluation scheme for cerebral time-resolved 3D contrast-enhanced MR angiography techniques.

BACKGROUND AND PURPOSE: No practical tool has been reported in the literature to evaluate the quality of cerebral TR-3D-CE-MRA techniques. Our study assessed a large list of parameters used to propose a quality-evaluation scheme for TR-3D-CE-MRA. MATERIALS AND METHODS: A large list of visual and quantitative parameters used to study the quality of images was collected from the literature and evaluated in 19 healthy patients and 11 patients with arteriovenous shunts who had undergone both CENTRA keyhole TR-3D-CE-MRA at 3T and CCA. Several observers evaluated the visual parameters, such as the diagnostic confidence index, artifacts, maximum vascular signal intensity, arterial-to-venous separation, and visibility of 17 arteries and 7 veins; and quantitative parameters, such as maximum arterial SI, arteriovenous transit time, arteriovenous contrast curve, and ADW. A statistical analysis was used to determine interobserver reproducibility of the visual parameters, to calculate the sensitivity of TR-3D-CE-MRA for detecting each vessel (with CCA as standard of reference), and to compare the results of the visual and quantitative evaluations. RESULTS: Diagnostic confidence index, artifacts, arterial-to-venous separation, and 4 vessels-the PICA, ophthalmic and occipital arteries, and the ISS-demonstrated high reproducibility and sensitivity. The ADW was the most reliable dynamic quantitative parameter and was correlated with arterial-to-venous separation. CONCLUSIONS: The image quality of TR-3D-CE-MRA can be effectively evaluated with a scheme of 1 quantitative and 7 visual parameters.

An integrated approach to distance learning with digital video in the French-speaking Virtual Medical University.

The aim of the French-speaking Virtual Medical University project (UMVF) is to share common resources and specific tools in order to improve medical training. Digital video on IP is an attractive tool for higher education but there are a number of obstacles to widespread implementation. This paper describes the UMVF approach to integrating digital video technologies and services in educational projects.

Doc'UMVF: two search tools to provide quality-controlled teaching resources in French to students and teachers.

The UMVF project is a federation of medical teaching resources covering 32 medical schools in France. Today, the indexing of these resources is carried out manually by the CISMeF team at the University Hospital of Rouen. This indexing is based on MeSH thesaurus. We use a subset of SCORM metadata standard. This choice was defined in collaboration with the French Medical Virtual University consortium (French acronym: UMVF). Currently, with the UMVF searching tool (called Doc'UMVF), medical students can reach more than 3300 resources useful in their curriculum. Doc'UMVF is developed in close collaboration between the medical informatics laboratories of Rennes and Rouen. In this paper we present two complementary searching tools based on different methods and which are integrated and used to improve both the relevance and the coverage rate of the answers. A specific searching module has been built to retrieve specific resources concerning the National Medical Exam ENC ("Examen National Classant") is also available. Nevertheless, due to lack of time, numerous resources are not yet indexed. Therefore we have decided to use also automatic indexing method (Nomindex). This approach will be improved by further research works, resulting from Rouen and Geneva teams. After having built a searching meta-motor, our objective is to develop a meta-tool intended to index the whole set of digital pedagogical resources produced by the UMVF framework. This manual re-indexing will be carried out only for the most important resources (national references), with a more or less fine granularity.

Managing educational resource in medicine: system design and integration.

The objective of this paper is to describe our experience in developing a tool based on web technologies, for storing, managing and providing medical courses written by professors in the medical university of Rennes. The increasing number of documents sent by professors leaded us to build a specific resource management system. We created a relational database, containing all meta information about each available document. Professors provide their courses in various formats. We use natural language parsing techniques to extract information from the text, and provide a proper semantic indexation which will be used by a medical-specific search engine. Then the content of our database is dynamically displayed on a web interface. A user's directory identifies teachers and students, controls the access, tracks the students' navigation and allows an on-line discussion forum. This portal contains 524 courses and we had more than 3,000,000 connections on it last year. We are now integrating its content using the semantic web approach in a larger project: the French Virtual Medical University.