医学数据资源共享中数据元著录的标准化方法研究

目的研究对数据元进行著录的标准化方法.方法首先建立数据元结构术语条目库,然后选择结构术语条目组成完整的数据元,最后进行数据元属性著录.结果根据数据元的定义、构成以及国家标准设计了一种数据元标准化著录方法.结论 对数据元进行标准化著录是医学数据资源共享的重要工作,需要按照相关标准选择合理的方法进行.     

超声网络教学数据库构建研究及应用

目的通过构建基于元数据的一站式网络检索数据库,以实现超声医学图书、教学资源及有声资料等网上共享,为本科教学与超声医学工作者任职教育提供全新教学平台。方法通过多种渠道收集六大类别超声学科相关资料数据,利用计算机技术将其编制成数据库。结果超声网络教学数据库在超声医学全数字化实时教学平台上正常运行,本科学生及医务人员均能方便查询、快捷进行自主学习。结论超声网络教学数据库保证教学与知识更新同步,有利于提高教学质量和自学能力,值得推广。     

计算机辅助医学图像三维重建的算法分析

背景:三维重建技术是采用计算机技术对二维医学图像进行边界识别,重新还原出被检组织或器官的三维图像.目的:分析在不同情况下进行医学图像三维重建时如何进行算法的选择.方法:采用计算机检索中国期刊全文数据库和Pubmed 数据库.中文检索词为"医学图像,三维重建,面绘制,体绘制",英文检索词为"medical images,three-dimensional reconstruction,surface rendering,volume rendering".检索与医学图像三维重建算法相关的文献33篇,从面绘制重置方法和体绘制重置方法的实现原理、实现复杂度、实时显示情况等方面进行分析.结果与结论:目前,医学图像三维重建根据绘制过程中数据描述方法的不同可分为三大类:面绘制方法、体绘制方法和混合绘制方法.通过对面绘制和体绘制方法中不同算法的分析,可以看到面绘制方法在算法效率和实时交互性上是优于体绘制的,虽然面绘制方法在绘制时候会丢失许多细节,使得绘制图像效果不理想,但是由于其算法比较简单,占用内存资源少,所以目前得到了广泛的运用.体绘制方法是对体数据场中的体素进行直接操作,可以绘制出三维数据场中更丰富的信息,因此体绘制方法的绘制效果优于面绘制方法.     

新安医学防治中风病数据库的设计与实现

中风病以其高发病率、高复发率、高致残率和高死亡率严重危害人类的健康。本课题借助现代计算机的智能化处理,以新安医家的诊疗方药为研究对象,利用VB语言和ACCESS数据库,建立新安医学防治中风病数据库,提供多种检索功能,促进资源共享,实现新安医学防治中风信息化。     

护理研究

Internet上与护理相关的信息资源浩如烟海,对于开展护理科研,实现资源共享和知识更新都起着重要的作用。查询网上护理信息一般通过两个途径：一是利用在线数据库,如美国国立医学图书馆的生物医学数据库Medline、万方数据资源系统、中国期刊网全文数据库等进行检索,二是利用搜索引擎,如Yahoo,Google等查找相关医学网站及网页。现将有关医学护理的网络资源及查询方法进行介绍。     

计算机辅助医学图像三维重建的算法分析

背景：三维重建技术是采用计算机技术对二维医学图像进行边界识别,重新还原出被检组织或器官的三维图像。目的：分忻在不同情况下进行医学图像三维重建时如何进行算法的选择。。方法：采用计算机检索中国期刊全文数据库和Pubmed数据库。中文检索词为“医学图像,三维重建,面绘制,体绘制”,英文检索词为“medicalimages,three—dimensionalreconstruction,surfacerendering,volumerendering”。检索与医学图像三维重建算法相关的文献33篇,从面绘制重置方法和体绘制重置方法的实现原理、实现复杂度、实时显示情况等方面进行分析。结果与结论：目前,医学图像三维重建根据绘制过程中数据描述方法的不同可分为三大类：面绘制方法、体绘制方法和混合绘制方法。通过对面绘制和体绘制方法中不同算法的分析,可以看到面绘制方法在算法效率和实时交互性上是优于体绘制的,虽然面绘制方法在绘制时候会丢失许多细节,使得绘制图像效果不理想,但是由于其算法比较简单,占用内存资源少,所以目前得到了广泛的运用。体绘制方法是对体数据场中的体索进行直接操作,可以绘制出三维数据场中更丰富的信息,因此体绘制方法的绘制效果优于面绘制方法。     

区域医疗卫生信息及影像数字化资源的共享战略

目的:探究区域医疗卫生信息及影像数字化资源共享的可持续发展途径.方法:直接走访和电话问卷调查作者所在省份44所医院相关信息,通过社区及公共传媒了解民众需求,对资源共享战略客观化分析.应用计算机检索中国期刊全文数据库(CNKI:2000/2010)、PubMed数据库等,检索词为"卫生信息,影像数字化,资源共享"和"medical treatment information,health information,images digitization",语言分别设定为中文和英文,排除重复性研究及较陈旧的文献.结果:医院信息几乎全部得到反馈,大多数认识肯定,部分医院上层有顾虑,关键要地方政府支持,民众是绝对的拥护.网络专业数据库得到266篇文章,238篇由于时间久远与现状相距较大或重复性研究原因被排除,最后纳入28文章作为参考.根据国内外医疗卫生信息化发展现状,摸索区域医疗卫生信息数字化以人为本、科学、协调的可持续发展捷径,特别是影像数字化共享方式以及优缺点和可行性.结论:应该对区域医疗卫生信息进行全方位整合,实现资源共享,为民众提供高水平的卫生与健康信息服务,减少医疗经济支出,体现新医改以人为本的原则.     

康复医学信息的检索

康复医学工作者无论在科研、教学和临床实际工作中时常面对康复医学专题或康复临床工作中的处理难题，需要各类康复医学信息，却不知如何有效检索相关的资料。本文介绍康复医学信息查询中通常所用的几种有效的检索方法及相应的检索工具。1手工检索手工检索是康复医学工作者最常用的方法1．1检索工具书①国内文献检索工具：《中文科技资料目录：医药卫生》、《中国医学文摘》、《中国药学文摘》、《中国生物学文摘》、《全国报刊索引》以及《国外医学·物理医学与康复学分册入②国外文献检索工具：主要是四大检索工具，美国《医学索引》（In…     

基于图割与粗糙集的MRI脑部肿瘤图像检索方法

背景:基于内容的医学图像检索是一门涉及多领域的学科,由于各种医学图像的成像原理不同,产生的图像在颜色、纹理和形状等视觉特征方面存在差别,使得此方法的实现还存在许多需要解决的问题.目的:针对基于内容的医学图像检索中存在特征提取困难、检索时间长的问题,提出一种基于图割与粗糙集结合的相似图像检索方法.方法:为克服图割仅适用于较少象素的图像和倾向于小割集的缺陷,首先对图像进行聚类,然后构建图像的Gomory-Hu割树,按割值大小依次去掉值较小的边,提取出图像的特征子图并构建特征库.为实现快速检索,借助粗糙集对特征库中的特征进行约简,有效减少参与相似性比较的特征数量.并将此方法应用到MRI脑部肿瘤图像的检索.结果与结论:实验结果表明该方法能快速有效地检索出MRI脑部图像库中的肿瘤图像,检索的平均查准率为78.4%,平均查全率为62.9%.     

数字人体研究及其应用

背景:数字人体研究是生命科学与信息科学结合的一个新的研究领域.国际上已经开展了一系列研究,如可视人计划、虚拟人计划、数字人计划等.目的:综述数字人体研究及其应用进展.方法:应用计算机检索2000-01/2010-01 CBM和CNKI数据库相关文章,同时利用Google搜索引擎检索相关网络信息资源.中文检索词为"数字人,虚拟人,可视人",英文检索词为"digital human,virtual human,visible human".共纳入24篇文献.结果与结论:数字人研究已由数字物理人步入了数字生理人阶段,在数字化医学高速发展的今天,如何应用信息技术将医学数字化、精准化、微创化、远程化,如何实现医学跨越式的转变,是医学信息工作者应该重点参与的一个课题.文章介绍了数字人研究的一系列计划,数字人模型,数字人研究的进展情况以及数字人研究在医学领域的科学意义.     

基于医疗健康信息集成规范-跨企业级文档共享技术的区域双向转诊互操作的研究与实现

背景:双向转诊可提高现有资源的有效利用率及卫生服务的社会效益,已成为解决社区卫生服务可持续发展的重要手段。目的:实现区域内不同医疗机构间患者医疗信息与医疗资源共享,构建双向转诊系统,推动区域卫生信息化建设。方法:从信息交互的互操作特点和重要性入手,深入分析了跨企业级文档共享技术框架下的角色和事务,研究具体的共享流程和实现方案,提出文档存储池和数据存储执行的策略,并在此基础上进行技术实现,构建双向转诊系统。结果与结论:在医疗健康信息集成规范-跨企业级文档共享技术的基础下,实现了双向转诊系统的构建,并在不同系统和机构之间进行了测试,结果证实该双向转诊系统可以有效和快捷的共享患者信息。     

CB6-02: UMLS as a Resource for VDW Infrastructure

Background/Aims UMLS (Universal Medical Language System) contains metadata for many of the data subject areas that make up the VDW. This metadata describes what codes mean, and their relationship with other codes, along with hierarchical structures that can be applied to the data subject area. Programs which run on the VDW often need to use code sets of disease, procedure, and medication classes. UMLS metadata could provide a uniform starting point for the development and maintenance of these code sets. Primary examples of the source systems included in UMLS are RxNorm (which contains NDCs), ICD-9 and ICD-10 which contain procedure and diagnosis codes, and HCPCS. Methods We propose that the ontology deployment programs which currently build i2b2 taxonomy querying interfaces be repurposed for the construction of standardized VDW metadata code sets and hierarchies. This metadata could be stored and shared in the VDW under a standardized specification. Documentation with links to the metadata could be made available on the CRN Portal, with both investigator and programming resources in mind. Such documentation will allow users to integrate the metadata into studies and programs by providing a menu of options and class systems that are available. Results UMLS has been very successfully used as a resource by Group Health in its i2b2 and SHRINE installations, providing the metadata needed to build the complex querying interface. The programs which accomplish this have been repurposed and we've built a prototype for VDW metadata table structure which encompasses pharmacy, procedure, and diagnosis data. We've built draft standard macros to query the metadata and create NDC lists based on an input class of drugs. The completeness of VDW procedures has been measured via UMLS metadata. Finally, we've identified areas of extreme interest which warrant additional research, such as the potential mapping of ICD-10 and ICD-9 codes via UMLS concept unique identifiers. Discussion The UMLS provides a standard way to distribute and prepare metadata that can be used for VDW research and infrastructure program code sets. Since this resource is freely available, well documented, and supported we recommend its adoption by other sites in their programs.     

上海市残疾人康复服务评价指标体系研究概述

本研究综合运用定性与定量研究方法,旨在构建上海市残疾人“人人享有康复服务”评价指标体系。根据研究目的,课题组对19区（县）残疾人康复工作和2个街道、镇的残疾人康复需求与服务情况进行了调查,召开了12场咨询论证会,实施了3轮Delphi调查,形成了有8个一级指标、32个二级指标和100个三级指标所构成的上海市残疾人“人人享有康复服务”评价指标体系并运用该指标体系对6个区进行了评审。     

NHS Reforms and Norfolk Physiotherapists

This article looks at aspects of the reforms in the NHS 1974–95 as they affected some Norfolk physiotherapists. The past thirty years have been a time of almost continual change in the National Health Service. This qualitative study, conducted in 1996, using data collected in audio-taped semi-structured interviews, attempted to discover how a sample of Norfolk physiotherapists perceived the way in which changes have occurred in the management and delivery of the physiotherapy service. Five main themes emerged from the data – concerning information management, management of the service, trusts and GP fundholding, physiotherapy practice, and relationships with the medical profession. As these were explored it became clear that physiotherapists' perception of change, as well as the material delivery of services, had been affected.     

Community children's nursing services in Wales: will the NSF make a difference?

The 2006 edition of the RCN Community Children's Nursing Directory lists 239 services--16 of which are based in Wales, 12 in Northern Ireland, two in the Channel Islands, one in the Isle of Man, 23 in Scotland and 185 in England. This listing highlights the continued development and expansion of services across the UK, as well as the further developments that are needed to ensure equity of provision in many areas. The lack of UK or national strategies means that services continue to be developed in an ad hoc way. The National Service Framework for Children, Young people and Maternity Services in Wales (NSF) includes the need for community nursing services in every area of Wales in its recommendations (Welsh Assembly Government (WAG) 2005). As with previous policy recommendations dating back almost 50 years, no additional resources have been provided and no funding has been ring fenced to enable trusts to achieve this key action. With services competing for limited resources there is the risk that community children's services will remain under funded and continue to develop in an ad hoc manner.     

Open-source platforms for navigated image-guided interventions

Navigation technology is changing the clinical standards in medical interventions by making existing procedures more accurate, and new procedures possible. Navigation is based on preoperative or intraoperative imaging combined with 3-dimensional position tracking of interventional tools registered to the images. Research of navigation technology in medical interventions requires significant engineering efforts. The difficulty of developing such complex systems has been limiting the clinical translation of new methods and ideas. A key to the future success of this field is to provide researchers with platforms that allow rapid implementation of applications with minimal resources spent on reimplementing existing system features. A number of platforms have been already developed that can share data in real time through standard interfaces. Complete navigation systems can be built using these platforms using a layered software architecture. In this paper, we review the most popular platforms, and show an effective way to take advantage of them through an example surgical navigation application.     

Brief report: Comparison of methods to identify Iraq and Afghanistan war veterans using Department of Veterans Affairs administrative data

The Department of Veterans Affairs (VA) has made treatment and care of Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans a priority. Researchers face challenges identifying the OIF/OEF population because until fiscal year 2008, no indicator of OIF/OEF service was present in the Veterans Health Administration (VHA) administrative databases typically used for research. In this article, we compare an algorithm we developed to identify OIF/OEF veterans using the Austin Information Technology Center administrative data with the VHA Support Service Center OIF/OEF Roster and veterans' self-report of military service. We drew data from two different institutional review board-approved funded studies. The positive predictive value of our algorithm compared with the VHA Support Service Center OIF/OEF Roster and self-report was 92% and 98%, respectively. However, this method of identifying OIF/OEF veterans failed to identify a large proportion of OIF/OEF veterans listed in the VHA Support Service Center OIF/OEF Roster. Demographic, diagnostic, and VA service use differences were found between veterans identified using our method and those we failed to identify but who were in the VHA Support Service Center OIF/OEF Roster. Therefore, depending on the research objective, this method may not be a viable alternative to the VHA Support Service Center OIF/OEF Roster for identifying OIF/OEF veterans.     

Rapid retrieval strategy for massive remote sensing metadata based on GeoHash coding

With the rapid development of Earth observation technology, satellite data centres have accumulated large amounts of remote sensing data from different spaceborne and airborne sensors. The efficient management and quick retrieval of multisource, massive and heterogeneous remote sensing data in the Big Data age have become increasingly important. In this paper, a spatio-temporal organization model based on GeoHash coding is proposed. First, based on the ISO standard, the heterogeneous remote sensing metadata can be converted into a unified format, and the differences in the multisource remote sensing metadata are screened. Then, the GeoHash algorithm is used to encode and convert the latitude and longitude coordinates of the remote sensing metadata to reduce the remote sensing metadata dimensions under space retrieval conditions. Finally, by building an HBase key value model based on GeoHash, a primary key is used to realize the rapid retrieval of massive remote sensing metadata through the simulation of 1500 million remote sensing metadata retrieval experiments; by comparing with the traditional multi-conditional filtering retrievals, the results show that a spatio-temporal organization strategy for remote sensing metadata based on GeoHash coding can effectively improve the efficiency of remote sensing data retrievals.     

世界卫生组织国际健康分类家族在康复中系统应用的方案与路线图

目的 研究世界卫生组织国际健康分类家族(WHO-FICs)在康复领域宏观层面的政策和理论架构、中观层面的治理与管理机制,以及微观层面的系统应用。方法 基于国际康复政策文件,主要是世界卫生组织《世界残疾报告》、《全球残疾行动计划》和《健康服务体系中的康复》等分析康复发展的政策理论架构;探讨WHO-FICs,包括《国际疾病分类》(ICD-11)、《国际功能、残疾和健康分类》(ICF)和《国际健康干预分类》(ICHIβ-2)三大参考分类在康复领域的系统应用。结果 基于WHO-FICs构建康复宏观政策和理论架构,明确现代康复服务的内涵和原则。康复服务是现代健康服务的重要组成部分,涉及6大要素,包括领导力与治理能力、筹资、健康人力资源、服务提供、医药技术和健康信息系统。要求在康复服务中依据ICD、ICF和ICHI的架构和知识体系,对康复领域的疾病、功能和干预的分类、命名规则、内涵、外延、术语体系和编码系统进行标准化,并完成康复相关的评估和统计。基于WHO-FICs构建康复治理与管理的中观机制。康复服务基于生物-心理-社会模式,坚持以人为本和功能定向原则;情景要素包括服务地点、服务设施和服务场景三个方面。在康复领域系统应用WHO-FICs推荐采用“评定(ICHI)–功能分类、评定、说明和编码(ICF)–疾病分类、诊断、编码(ICD-11)–康复干预(ICHI)”系统应用模式,遵循“评估(功能和需求)和诊断(疾病和功能)–确定康复目标和康复方案–实施康复干预–康复结局评价(功能评定)”的标准化流程。基于WHO-FICs构建康复的微观应用模式,明确康复涉及的主要疾病有28大类,主要功能障碍有7大类,康复干预有6大类。根据ICD-11和ICF推荐的整体功能评估工具有WHO残疾评定方案(WHODAS 2.0)、WHO示范残疾评估表简明版(MDS-B)和VB40通用功能领域(VB40),同时推荐ICF核心分类组合用于康复功能和康复结局的评估。WHO-FICs在康复病案管理和病案首页报告中的应用,可实现康复病案管理的标准化,基于康复病案首页的疾病、功能和干预编码以及康复绩效报告的标准化为康复付费和支付管理提供了工具。基于WHO-FICs构建标准康复数据集,建立标准化康复大数据,实现功能相关的诊断相关分类和case-mix统计。结论 将WHO-FICs分类系统应用于康复领域,在宏观层面构建康复理论和政策架构,在中观层面明确康复治理与管理的机制,在微观层面建立康复应用模式,可进一步提升康复服务的科学化、规范化、精细化和信息化水平,提升康复服务的治理水平和治理能力,提高康复服务的质量、安全性和覆盖率,提供科学有效的整体解决方案。     

EMS systems in China

The prehospital emergency service is the initial part of the Emergency Medical Service System (EMSS) in China, and is the de facto overall emergency medical service for China. As the EMSS in China continues to undergo rapid development, it faces the challenge of providing rapid response times with adequate coverage for this highly populated country. The recent Sichuan earthquake on 12 May 2008 tested the ability of the EMSS response. This article focuses on the prehospital emergency service of the EMSS and discusses the strengths and weaknesses of the current system.