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  • 1.
    Alickovic, Emina
    et al.
    Linköping University, Department of Electrical Engineering, Automatic Control. Linköping University, Faculty of Science & Engineering.
    Subasi, Abdulhamit
    Effat University, Saudi Arabia.
    Medical Decision Support System for Diagnosis of Heart Arrhythmia using DWT and Random Forests Classifier2016In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 40, no 4, p. 108-Article in journal (Refereed)
    Abstract [en]

    In this study, Random Forests (RF) classifier is proposed for ECG heartbeat signal classification in diagnosis of heart arrhythmia. Discrete wavelet transform (DWT) is used to decompose ECG signals into different successive frequency bands. A set of different statistical features were extracted from the obtained frequency bands to denote the distribution of wavelet coefficients. This study shows that RF classifier achieves superior performances compared to other decision tree methods using 10-fold cross-validation for the ECG datasets and the obtained results suggest that further significant improvements in terms of classification accuracy can be accomplished by the proposed classification system. Accurate ECG signal classification is the major requirement for detection of all arrhythmia types. Performances of the proposed system have been evaluated on two different databases, namely MIT-BIH database and St. -Petersburg Institute of Cardiological Technics 12-lead Arrhythmia Database. For MIT-BIH database, RF classifier yielded an overall accuracy 99.33 % against 98.44 and 98.67 % for the C4.5 and CART classifiers, respectively. For St. -Petersburg Institute of Cardiological Technics 12-lead Arrhythmia Database, RF classifier yielded an overall accuracy 99.95 % against 99.80 % for both C4.5 and CART classifiers, respectively. The combined model with multiscale principal component analysis (MSPCA) de-noising, discrete wavelet transform (DWT) and RF classifier also achieves better performance with the area under the receiver operating characteristic (ROC) curve (AUC) and F- measure equal to 0.999 and 0.993 for MIT-BIH database and 1 and 0.999 for and St. Petersburg Institute of Cardiological Technics 12-lead Arrhythmia Database, respectively. Obtained results demonstrate that the proposed system has capacity for reliable classification of ECG signals, and to assist the clinicians for making an accurate diagnosis of cardiovascular disorders (CVDs).

  • 2.
    Carlsson, Mats
    et al.
    Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
    Löfström, Lars
    Linköping University, Faculty of Health Sciences.
    Åhlfeldt, Hans
    Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
    Classification of procedures in the domain of thoracic surgery: a study of relibility in coding2001In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 25, no 1, p. 47-61Article in journal (Refereed)
    Abstract [en]

    This paper relates a study of reliability of coding of surgical procedures in the domain of thoracic surgery. The reliability measured is inter-coder variability in form of agreement. Four classifications were used by four physicians on 100 patient cases. The classifications, having differing granularity and structure, were analyzed using a statistical method (kappa). These results are discussed and related to the differences between the classifications. One of the topics for discussion is how the granularity affects the degree of agreement, coupled to the usefulness of the classification. Also the concept of using formal methods for representing classifications is discussed, how this will affect how classifications are designed and used.

  • 3.
    Chowdhury, Shamsul
    et al.
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Linnarsson, Rolf
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Wallgren, Anders
    Dept of Statistics Sween Örebro.
    Wallgren, Britt
    Dept Statistics Sweden Örebro.
    Wigertz, Ove
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Extracting knowledge from a large primary health care database using a knowledge-based statistical approach1990In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 14, no 4, p. 213-225Article in journal (Refereed)
  • 4.
    Chtziarsenis, M
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice.
    Lionis, C
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice.
    Makri, E
    Sapouna, K
    Fioretos, M
    Faresjö, Tomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice.
    Mavromanolakis, M
    Vlachonikolis, J
    Trell, Erik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice.
    Bringing community involvement into a Cretan primary/hospital care centrel.1999In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 23, p. 123-131Article in journal (Refereed)
  • 5.
    Dahlström, Örjan
    et al.
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Thyberg, Ingrid
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences.
    Hass, Ursula
    Linköping University, Department of Medicine and Health Sciences, Health Technology Assessment. Linköping University, Faculty of Health Sciences.
    Skogh, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Rheumatology . Linköping University, Faculty of Health Sciences.
    Timpka, Toomas
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Designing a decision support system for existing clinical organizational structures: Considerations from a rheumatology clinic2006In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 30, no 5, p. 325-331Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to identify the social and organizational requirements for a decision support system (DSS) to be implemented in a clinical rheumatology setting, utilizing data-mining techniques. Field observations and focus group interviews were used for data collection. The decision-making was found to be situated, patient-focused, and long-term in nature. At the same time, the main part of peer-to-peer communication was informal. Patient records were involved in almost every decision. The conclusion is that the main challenges, when introducing a DSS at a rheumatology unit, are adapting the system to informal communication structures and integrating it with patient records. Considering incentive structures, understanding workflow and incorporating awareness are relevant issues when addressing these issues in future studies.

  • 6.
    Dinka, David
    et al.
    Linköping University, The Institute of Technology. Linköping University, Department of Computer and Information Science, MDALAB - Human Computer Interfaces.
    Nyce, J.M.
    Timpka, Toomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Östergötlands Läns Landsting, FHVC - Folkhälsovetenskapligt centrum.
    Holmberg, K.
    Adding value with 3D visualization and haptic forces to radiosurgery - A small theory-based, quasi-experimental study2006In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 30, no 4, p. 293-301Article in journal (Refereed)
    Abstract [en]

    This study investigates the use of 3D representation and haptic technology in radiosurgery. The users, experienced users of the Leksell GammaKnife, prefer the 3D representation for constructing a first draft of their plan for neurosurgical intervention. When it comes to the final adjustments, however, they still choose the traditional 2D representation and interaction devices. The perceived control over the radiosurgical process is not considered adequate using the 3D interaction methods. Practitioners do not consider the haptic forces implemented in this test system useful. Possible explanations for these findings are discussed in the paper. © Springer Science+Business Media, Inc. 2006.

  • 7.
    Hassling, Linda
    et al.
    Linköping University, The Institute of Technology. Linköping University, Department of Computer and Information Science, MDALAB - Human Computer Interfaces.
    Babic, Ankica
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Lönn, Urban
    Ahn, Henrik Casimir
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    A web-based patient information system - identification of patients' information needs2003In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 27, no 3, p. 247-257Article in journal (Refereed)
  • 8.
    Irestig, Magnus
    et al.
    Linköping University, The Institute of Technology. Linköping University, Department of Computer and Information Science, MDALAB - Human Computer Interfaces.
    Niklas, Hallberg
    FOI.
    Eriksson, Henrik
    Linköping University, The Institute of Technology. Linköping University, Department of Computer and Information Science, MDALAB - Human Computer Interfaces.
    Timpka, Toomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Östergötlands Läns Landsting, Centre for Public Health Sciences, Centre for Public Health Sciences.
    Peer-to-peer computing in health-promoting voluntary organizations: A system design analysis2005In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 29, no 5, p. 425-440Article in journal (Refereed)
    Abstract [en]

    A large part of the health promotion in today's society is performed as peer-to-peer empowerment in voluntary organisations such as sports clubs, charities, and trade unions. In order to prevent work-related illness and long-term sickness absence, the aim of this study is to explore computer network services for empowerment of employees by peer-to-peer communication. The 'technique trade-off' method was used for the analysis of the system design. A Critical Incident Technique questionnaire was distributed to a representative sample of trade union shop stewards (n = 386), and focus-group seminars were arranged where a preliminary set of requirements was discussed. Seven basic requirements were identified and matched to a set of 12 design issues for computer network services, allocating a subset of design issues to each requirement. The conclusion is that the systems design displays an inexpensive and potentially feasible method for peer-to-peer computing in voluntary health-promoting organisations. © 2005 Springer Science+Business Media, Inc.

  • 9.
    Kohli, Sunil
    et al.
    Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
    Sahlén, K.
    Sivertun, Åke
    Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
    Löfman, Owe
    Linköping University, Department of Department of Health and Society. Linköping University, Faculty of Health Sciences.
    Trell, Erik
    Linköping University, Department of Department of Health and Society, General Practice. Linköping University, Faculty of Health Sciences.
    Wigertz, Ove
    Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
    Distance from the primary health center: a GIS method to study geographical access to health care1995In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 19, no 6, p. 425-436Article in journal (Refereed)
    Abstract [en]

    Aerial distance from the dependent Primary Health Center is a crude but objective measure of geographical accessibility to Primary Health care facilities. This report describes a method for calculation of distances between the PHC and the population it serves using the data available from the local health authorities and the Swedish Central Statistical Bureau. The Swedish annual population registration records of 1991 and the property register available with the Central Statistical Bureau of Sweden formed the main data sources. By coupling the address in the population register to the property register each individual was mapped to the centroid of a property. The location of the PHCs as well as the areas covered by each were obtained from the local health authorities and mapped. By intersecting the population coverage with the PHC coverage the population for each PHC area was identified. Subsequently the distance to the PHC was calculated for each individual (property centroid). The population maps so generated can be linked to other databases to visualize and analyze the spatial dimension of health and disease. The methodology can be adapted for use with postal code districts, census enumeration tracts, or any other small area.

  • 10.
    Liszka-Hackzell, Jan J.
    Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
    Categorization of fetal heart rate patterns using neural networks2001In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 25, no 4, p. 269-276Article in journal (Refereed)
    Abstract [en]

    Digitized data from CTG (cardiotocography) measurements (fetal heart rate and uterine contractions) have been used for categorization of typical heart rate patterns before and during delivery. Short time series of CTG data, about 7 min duration, have been used in the categorization process. In the first part of the study, selected CTG data corresponding to 10 typical cases were used for purely auto associative unsupervised training of a Self-Organizing Map Neural Network (SOM). The network may then be used for objective categorization of CTG patterns through the map coordinates produced by the network. The SOM coordinates were then compared. In the second part of the study, a hybrid neural network consisting of a SOM network and a Back-Propagation network (BP) was trained with data corresponding to a number of basic heart rate patterns as described by eight manually selected indices. Test data (different than the training data) were then used to check the performance of the network. The present study shows that the categorization process, in which neural networks were used, can be reliable and agree well with the manual categorization. Since the categorization by neural networks is very fast and does not involve human efforts, it may be useful in patient monitoring.

  • 11.
    Liszka-Hackzell, Jan J.
    et al.
    Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
    Ekback, Gustaf
    Department of Anesthesiology and Intensive Care, Örebro Medical Center Hospital, Örebro, Sweden.
    Analysis of the information content in sonoclot data and reconstruction of coagulation test variables2002In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 26, no 1, p. 1-8Article in journal (Refereed)
    Abstract [en]

    The Sonoclot Coagulation AnalyzerTM is a viscoelastometer used for in vitro analysis of the coagulation process from the start of fibrin formation, through polymerization of the fibrin monomer, platelet interaction, and eventually to clot retraction and lysis. In this paper, we have analyzed series of Sonoclot curves and simultaneously obtained coagulation tests (APT, PT, Fibrinogen, Platelet Count, and D-dimer) from patients who underwent total hip replacements (THA). By using the Principal Component Analysis method (PCA), we found that the most important coagulation test variables as reflected in the Sonoclot signature, are Platelet Count, PT, and Fibrinogen. Also, by using a Back-Propagation Neural Network (BP), we were able to reconstruct the coagulation variables Platelet Count, PT, and Fibrinogen from the Sonoclot curve with a reasonable accuracy. This would also indicate that these three coagulation test variables are most important in determining the appearance of the Sonoclot signature.

  • 12.
    Liszka-Hackzell, John J.
    et al.
    Department of Anesthesiology, Örebro Medical Center Hospital, Örebro, Sweden.
    Martin, David
    Department of Anesthesiology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota.
    Categorization and analysis of pain and activity in patients with low back pain using neural network technique2002In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 26, no 4, p. 337-347Article in journal (Refereed)
    Abstract [en]

    Low back pain represents a significant medical problem, both in its prevalence and its cost to society. Most episodes of acute low back pain resolve without significant long-term functional impact. However, a minority of patients experience extended chronic pain and disability. In this paper, we have explored new techniques of patient assessment that may prospectively identify this minority of patients at risk of developing poor outcomes. We studied 15 patients with acute low back pain and 25 patients with chronic low back pain over 4 month's time. Patients monitored their pain and activity levels continuously over the first 3 weeks. Pain and functional status were assessed at baseline and at 3 weeks following enrollment. Follow-up assessment of functional status and progress were performed at 2 and 4 months. The pain and activity levels were categorized using a self-organizing-map neural network. A back-propagation neural network was trained with the categorization and outcome data. There was a good correlation between the true and predicted values for general health (r = 0.96, p < 0.01) and mental health (r = 0.80, p < 0.01). No significant correlation was found if activity and pain data were not entered into the analysis. Our results show that neural network techniques can be applied effectively to categorizing patients with acute and chronic low back pain. It is our hope that future research will allow these categorizations to be tied to prognostic and therapeutic decisions in patients who present with episodes of back pain.

  • 13.
    Lorentzson, B
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice.
    Trell, Erik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice.
    Introduzing the Theme in a Qualitative Interview Using a Visual Starter.1999In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 23, p. 437-446Article in journal (Refereed)
  • 14.
    Mettler, Tobias
    et al.
    University of Lausanne, Switzerland.
    Vimarlund, Vivian
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering.
    All that Glitters is not Gold: Six Steps Before Selecting and Prioritizing e-Health Services2017In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 41, no 10, article id 154Article in journal (Refereed)
    Abstract [en]

    Since the market for e-health applications is constantly growing, it is getting an ever more complex endeavor to select and prioritize the right service offering given a particular situation. In examining the extant literature, it was revealed that little emphasis is actually placed on how to analyze contextual or environmental factors prior to the selection and prioritization of e-health services. With this paper, we therefore propose a formative framework consisting of six fundamental yet very pragmatic steps that may support decision makers in identifying the most important contextual pre-requisites that e-health services need to fulfill in order to be considered as effective for their environment to be implemented.

  • 15.
    Moidu, Khalid
    et al.
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Wigertz, Ove
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Computer based information systems in primary health care - Why?1989In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 13, no 2, p. 59-64Article in journal (Refereed)
  • 16.
    Moidu, Khalid
    et al.
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Wigertz, Ove
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Trell, Erik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice.
    A multicenter study of data collection and communication at primary health care centers1991In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 15, no 3, p. 205-230Article in journal (Refereed)
  • 17.
    Nadri, Hamed
    et al.
    Urmia University of Medical Science, Iran.
    Rahimi, Bahlol
    Urmia University of Medical Science, Iran.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Science & Engineering. Region Östergötland, Center for Business support and Development, Department of Health and Care Development.
    Sedghi, Shahram
    Iran University of Medical Science, Iran.
    The Top 100 Articles in the Medical Informatics: a Bibliometric Analysis2017In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 41, no 10, article id 150Article in journal (Refereed)
    Abstract [en]

    The number of citations that a research paper receives can be used as a measure of its scientific impact. The objective of this study was to identify and to examine the characteristics of top 100 cited articles in the field of Medical Informatics based on data acquired from the Thomson Reuters Web of Science (WOS) in October, 2016. The data was collected using two procedures: first we included articles published in the 24 journals listed in the "Medical Informatics" category; second, we retrieved articles using the key words: "informatics", "medical informatics", "biomedical informatics", "clinical informatics" and "health informatics". After removing duplicate records, articles were ranked by the number of citations they received. When the 100 top cited articles had been identified, we collected the following information for each record: all WOS database citations, year of publication, journal, author names, authors affiliation, country of origin and topics indexed for each record. Citations for the top 100 articles ranged from 346 to 7875, and citations per year ranged from 11.12 to 525. The majority of articles were published in the 2000s (n=43) and 1990s (n=38). Articles were published across 10 journals, most commonly Statistics in medicine (n=71) and Medical decision making (n=28). The articles had an average of 2.47 authors. Statistics and biostatistics modeling was the most common topic (n=71), followed by artificial intelligence (n=12), and medical errors (n=3), other topics included data mining, diagnosis, bioinformatics, information retrieval, and medical imaging. Our bibliometric analysis illustrated a historical perspective on the progress of scientific research on Medical Informatics. Moreover, the findings of the current study provide an insight on the frequency of citations for top cited articles published in Medical Informatics as well as quality of the works, journals, and the trends steering Medical Informatics.

  • 18.
    Rahimi, Bahlol
    et al.
    Linköping University, Department of Computer and Information Science, MDALAB - Human Computer Interfaces. Linköping University, The Institute of Technology.
    Vimarlund, Vivian
    Linköping University, Department of Computer and Information Science, MDALAB - Human Computer Interfaces. Linköping University, The Institute of Technology.
    Methods to Evaluate Health information Systems in Healthcare Settings: A Literature Review2007In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 31, no 5, p. 397-432Article in journal (Refereed)
    Abstract [en]

    Although information technology (IT)-based applications in healthcare have existed for more than three decades, methods to evaluate outputs and outcomes of the use of IT-based systems in medical informatics is still a challenge for decision makers, as well as to those who want to measure the effects of ICT in healthcare settings. The aim of this paper is to review published articles in the area evaluations of IT-based systems in order to gain knowledge about methodologies used and findings obtained from the evaluation of IT-based systems applied in healthcare settings. The literature review includes studies of IT-based systems between 2003 and 2005. The findings show that economic and organizational aspects dominate evaluation studies in this area. However, the results focus mostly on positive outputs such as user satisfaction, financial benefits and improved organizational work. This review shows that there is no standard framework for evaluation effects and outputs of implementation and use of IT in the healthcare setting and that until today no studies explore the impact of IT on the healthcare system’ productivity and effectiveness.

  • 19.
    Rahimi, Bahlol
    et al.
    Linköping University, Department of Computer and Information Science, MDALAB - Human Computer Interfaces. Linköping University, The Institute of Technology.
    Vimarlund, Vivian
    Linköping University, Department of Computer and Information Science, MDALAB - Human Computer Interfaces. Linköping University, The Institute of Technology.
    Timpka, Toomas
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Public Health Sciences.
    Health Information System Implementation: A Qualitative Meta-analysis2009In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 33, no 5, p. 359-368Article in journal (Refereed)
    Abstract [en]

    Healthcare information systems (HISs) are often implemented to enhance the quality of care and the degree to which it is patient-centered, as well as to improve the efficiency and safety of services. However, the outcomes of HIS implementations have not met expectations. We set out to organize the knowledge gained in qualitative studies performed in association with HIS implementations and to use this knowledge to outline an updated structure for implementation planning. A multi-disciplinary team performed the analyses in order to cover as many aspects of the primary studies as possible. We found that merely implementing an HIS will not automatically increase organizational efficiency. Strategic, tactical, and operational actions have to be taken into consideration, including management involvement, integration in healthcare workflow, establishing compatibility between software and hardware and, most importantly, user involvement, education and training. The results should be interpreted as a high-order scheme, and not a predictive theory.

  • 20.
    Ridderstolpe, Lisa
    et al.
    Linköping University, Department of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
    Gill, Hans
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Borga, Magnus
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Rutberg, Hans
    Östergötlands Läns Landsting, Heart Centre.
    Åhlfeldt, Hans
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Canonical correlation analysis of risk factors and clinical outcomes in cardiac surgery2005In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 29, no 4, p. 357-377Article in journal (Refereed)
    Abstract [en]

    Assessment of the association between risk factors and outcomes in cardiac surgery is a complex problem. The aim of this study was to explore the relationship between possible risk factors and several clinical outcomes in cardiac surgery by using canonical correlation analysis (CCA). This retrospective study of 2605 consecutive adult patients who underwent cardiac surgery, evaluated 74 potential risk factors and up to 12 outcomes by canonical correlation analysis. For three serious outcomes, sternal wound complications/mediastinitis, cerebral complications, and perioperative myocardial infarctions, CCA was preceded by univariate analyses and backward stepwise multivariate logistic regression analyses. The CCA suggests that the major risk factors for complications in these models are intraoperative and postoperative risk factors. The power of risk prediction models developed with multivariate regression analysis can be enhanced by application of canonical correlation analysis, thereby offering new ways of analyzing and interpreting sets of potential risk factors in relation to sets of clinical outcomes.

  • 21.
    Ridderstolpe, Lisa
    et al.
    Linköping University, Department of Biomedical Engineering. Linköping University, The Institute of Technology.
    Johansson, Andreas
    Ensolution AB, TeknoCenter, Halmstad, Sweden.
    Skau, Tommy
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences.
    Ruthberg, Hans
    Östergötlands Läns Landsting, Heart Centre.
    Åhlfeldt, Hans
    Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
    Clinical process analysis and activity-based costing at a heart center2002In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 26, p. 309-322Article in journal (Refereed)
    Abstract [en]

    Cost studies, productivity, efficiency, and quality of care measures, the links between resources and patient outcomes, are fundamental issues for hospital management today. This paper describes the implementation of a model for process analysis and activity-based costing (ABC)/management at a Heart Center in Sweden as a tool for administrative cost information, strategic decision-making, quality improvement, and cost reduction. A commercial software package (QPR®) containing two interrelated parts, “ProcessGuide and CostControl,” was used. All processes at the Heart Center were mapped and graphically outlined. Processes and activities such as health care procedures, research, and education were identified together with their causal relationship to costs and products/services. The construction of the ABC model in CostControl was time-consuming. However, after the ABC/management system was created, it opened the way for new possibilities including process and activity analysis, simulation, and price calculations. Cost analysis showed large variations in the cost obtained for individual patients undergoing coronary artery bypass grafting (CABG) surgery. We conclude that a process-based costing system is applicable and has the potential to be useful in hospital management.

  • 22.
    Singh, Ashok K.
    et al.
    Dept general practice HU Linköping.
    Kohli, Sunil
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Moidu, Khalid
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Boström, Karin
    Dept Obstretics and Gynecology HU Linköping.
    Trell, Erik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice.
    Wigertz, Ove
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Primary health care computing analysis of Swedish maternal health records1994In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 18, no 5, p. 221-228Article in journal (Refereed)
  • 23.
    Spång, L
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice.
    Thireos, E A
    Lionis, C
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice.
    Trell, Erik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice.
    Face and Contents Validity, and Feasibility of Healthometer. A Delphi Study.1999In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 23, no 6, p. 457-465Article in journal (Refereed)
    Abstract [en]

    Our recent descriptive report in this journal of "Healthometer," an interactive instrument for self-mediated health counseling, was well received in the medical systems research and development community. Suitable for paper as well as electronic mediation and covering both screening, processing/storage, and advisory tasks in a positively reinforcing and confidential way, it has on the whole been considered to be an interesting model in the advancing "information society technologies" perspective, however, a closer scientific and operative evaluation is warranted. Because the power of the instrument in addition to the hardware is critically dependent upon the wet- and software quality, the present study aims at examining in the same forefront forum some basic aspects of all these modalities, with emphasis on face and content validity, feasibility, and users' attitudes and opinions. It can be summarized, quite briefly, that all of them were satisfactory.

  • 24.
    Vimarlund, Vivian
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Sjöberg, Cecilia
    Swedish Agency for Innovation Systems, Stockholm, Sweden.
    Timpka, Toomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    A theory for classification of health care organizations in the new economy2003In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 27, no 5, p. 465-473Article in journal (Refereed)
  • 25.
    Voznuka, Natalja
    et al.
    Linköpings universitet.
    Granfeldt, Hans
    Hjärtcentrum Hälsouniversitetet.
    Babic, Ankica
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Storm, Markus
    Linköpings universitet.
    Lönn, Urban
    Uppsala University Hospital.
    Ahn, Henrik Casimir
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Report generation and data mining in the domain of thoracic surgery2004In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 28, no 5, p. 497-509Article in journal (Refereed)
    Abstract [en]

    As a part of AssistMe system, the reporting system has been developed for the thoracic surgery domain. Reporting System is defined as software for dynamic report generation purpose and based on the data-mining techniques. The target users of the future reporting system - physicians, administrative staff, and patients - have been identified. Two major types of clinical reports have been found: predefined and customized. The decision of splitting reports into groups has been taken mainly because users were heterogeneous and had different access rights to the sensitive information. Data-mining process in the reporting system is based on descriptive statistics. It allows dynamically mined AssistMe databases and generates statistical reports about patient's morbidity, mortality, and comorbidity. Information is visualized in the chart way and can be also observed in tabular form. User interaction is also supported by the system.

  • 26.
    Wass, Sofie
    et al.
    Jonkoping Univ, Sweden.
    Vimarlund, Vivian
    Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Science & Engineering. Jonkoping Univ, Sweden.
    The Role of PAEHRs in Patient Involvement2018In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 42, no 11, article id 210Article in journal (Refereed)
    Abstract [en]

    With increased patient access to data, healthcare services are experiencing change where patients are moving away from being mere passive actors towards becoming more active and involved participants. In this paper, we explore the role of patient accessible electronic health records (PAEHRs) with respect to this increase in patient involvement. The study was performed as a case study and included nine interviews with patients and a survey that was responded to by 56 patients. Our results show that PAEHRs have a role in the enhancement of patient involvement because PAEHRs (i) foster a more balanced relationship between patients and healthcare professionals and (ii) increase access to information.

  • 27.
    Wilhelmsson, Susan
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Åkerlind, Ingemar
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    Faresjö, Tomas
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Assessment of Psychosocial Work Environment in Primary Care: Development of a Questionnaire1999In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 23, no 6, p. 447-456Article in journal (Refereed)
    Abstract [en]

    Recent studies have indicated deteriorated working conditions of health care personnel. To have an efficient health care organization requires good working conditions and the well-being of the personnel. Today there are no 'gold-standard' assessment tools measuring psychosocial working conditions. The aim of this study was to develop two valid and reliable questionnaires, one generic and one specific, measuring psychosocial working conditions for general practitioners (GPs) and district nurses (DNs) in Sweden, with a special emphasis on organizational changes. The construction of the questionnaires were made after a stepwise developing phase including literature review, interviews, and a pilot study. The pilot study included GPs n = 42 and DNs n = 39. The questionnaires were later on used in a main study (GPs n = 465, DNs n = 465). A factor analysis was carried out and showed that there were fewer items in the main study that had factor loading ≥ 0.40 in more than one factor, compared to the pilot study. The factors from the main study were easier to label and had good correspondence with other studies. After this stepwise development phase good construct validity and internal consistency were established for the questionnaire.

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