Medical Informatics Europe 1991 : Proceedings, Vienna, Austria, August 19-22, 1991

This volume contains the proceedings of the Tenth International Congress on Medical Informatics, MIE 91, that will be held in Vienna, Austria, August 19-22, 1991. The MIE 91 Congress was organized by the European Federation for Medical Informatics (EFMI) in cooperation with the Austrian Computer Society (OCG) and the Austrian Society for Biomedi­ cal Engineering (OGBMT). It follows the previous congresses in Cambridge (1978), Berlin (1979), Toulouse (1981), Dublin (1982), Brussels (1984), Helsinki (1985), Rome (1987), Oslo (1988), and the Congress 1990 in Glasgow. The proceedings contain 199 contributions to the MIE 91 Congress. They cover all presentations which are part of the scientific programme of MIE 91, among them 157 paper presentations with an average of five pages, 28 poster presentations again with an average of five pages, and 14 abstracts of demonstrations with an average of one page. The papers included were selected by an International Programme Committee out of over 300 submissions after careful review by at least two international reviewers (for whose estimable efforts we are especially thankful). The recommendations of the re­ viewers were incorporated in the final texts. Some papers were reworked by a professional translator to obtain a high quality of presentation. Several submissions could not be considered for presenta­ tion at MIE 91 because of shortage of congress time and limitations in the number of pages of the proceedings.

Paper Presentations.- Keynote Addresses.- Knowledge-Based Systems in Medicine.- Perspectives of Computer Assisted Medical Imaging.- Medical Languages: Use, Definition and Processing in Ward Information Systems (WIS).- Informatics in Molecular Biology.- Hospital Information Systems.- WAMIS—Heuristic Approaches to a Medical Information Network.- “The Vienna Hospital Information System” EDP-Assisted Management of the City of Vienna.- The Information System of the Freiburg University Hospital.- Overview of an Architectural Approach to the Development of the A.Z.-V.U.B. Distributed Clinical Information System.- The Medical Record Linkage Process Within the Diogene Hospital Information System.- Computers in Hospitals, Vulnerability Aspects.- Nursing Information Systems — A State of the Art Study.- Converting American Software for European HIS Requirements.- Departmental Information Systems.- The Concept of a Ward Information System.- DAMS—Software Package to Support the Daily Activities of a Hospital Ward.- The FEBE Project: Designing a Clinical Information System.- A Ward Nursing System Integrated in a Comprehensive HIS.- A Distributed System for the Integrated Management of General and Subspecialist Pediatric Outpatient Clinic.- Experiences with PATSY: An Information System for Pathology.- Low-Cost Hospital Informatics in Africa: The Ile-Ife Experience.- Data Modelling for Intensive Care within the INFORM Project.- A Temporal Database Management for Medical and Health Care Systems.- SYGMA: A General Object-Oriented Medical Application Development System.- What Should We Mean by ‘An Electronic Medical Record’?.- Requirements for a Medical Workstation Using User-Centred Design.- The Use of a Touch-Screen Computer for Dental Charting.- A.RE.S.: An Interface for Automatic Reporting by Speech.- Hospital Communication Networks and Pacs.- The NHS Interoperability Testing Facility (ITF).- PC Network for Hospital Information System.- A Hospital Communication System Based on CON-NECT—Medical User Interfaces.- MIDAM—A Generalised System for Integrating Medical Images and Patient Records.- The Integration of PACS, Digital Radiography, Nuclear Medicine and Ultrasound Devices: An Opportunity and a Challenge for the General Hospital.- Modular Development of a Hospital Wide Picture Archiving and Communication System (PACS).- Planning a Large Scale PACS: The Vienna SMZO-Project.- Drug Information and Decision Support Systems.- Drug Interactions in Primary Care—A Retrospective Database Study.- Drug Utilization Monitoring in the Clinical Hospital Centre-Zagreb.- Knowledge-Based Galenical Development of Drug Products: An Overview on the Design of the Galenical Development System Heidelberg.- Development of an Expert System for the Detection of Adverse Drug Reactions.- Information Systems and Decision Support.- Advice and Warning within HIOS+.- Strategies for Efficient Implementation of the Arden Syntax for Medical Decision Support.- Development of Computerized Neurological Decision Support System.- ProtoVIEW: A Workstation for the Use of Clinical Algorithms.- Expert Systems.- DIANA 2/ The Diagnostic Analyzer: Diagnostic Consultation in Internal Medicine by Personal Computer.- SPES-2: An Expert System for the Intra-Operative Phase of the Pancreas Cancer.- Computer-Aided Expert System of Diagnostics and Tactics in Acute Urgent Neurologic Pathology.- Differential Diagnosis in Breast Histopathology.- FUMIDS (Fever of Unknown Origin in Miscellaneous Diseases Diagnosis System): Development and Assessment.- A Bayesian Approach to the Detection of Acute Disorders in a Respiratory Intensive Care Unit.- Expert System “DINAR-2”—Methodological Basis for the Pediatric Emergency Aid Organization in a Large Region.- An Expert System for the Diagnosis, Treatment, and Triage of Head Injuries in Remote Environments.- Expert Systems—Knowledge Representation.- A Model for the Systematic Application of Artificial Intelligence in the Diagnosis of Pathologic Conditions in a System or Apparatus.- UnPatient: A Knowledge Base for Medical Diagnostic Expert Systems.- Interpretation of Clinical Biochemistry Test Profiles by a Method Allowing Communication Between Linked Organ-Related Knowledge Bases.- Declarative and Operational in Knowledge-Based Systems.- The Operational Aspects of Object-Oriented Approach in Medical Expert Systems Design.- Design of a Well-Protected Patient Record Unit for Multi-Centre Knowledge-Based System CLINAID.- Expert Systems—Knowledge Acquisition and Learning.- Better Justifiability and Less Rules by Using Deep Knowledge.- Learning Specialized Disease Descriptions in a Rheumatological Expert System.- Inductive Learning as a Method for Medical Decision Making.- Knowledge Acquisition Study and Accuracy Rate Evaluation for CADIAG-2/RHEUMA with 308 Clinical Cases.- Knowledge Acquisition in Medicine: Enforcing Consistency.- Medical Knowledge Base Consistency Checking and its Application to CADIAG-1/BIN.- Associative Memories in Medical Diagnostic.- Using Connectionist Approach for Finding Ideal Cut-Off Values for Quantitative Laboratory Tests.- Expert Systems—Evaluation.- A Methodology for Evaluation of Knowledge-Based Systems.- Outcomes Assessment, Quality Assurance and Evaluation of Expert Diagnostic Systems.- Software Tools for the Development and Validation of HEPAR, an Expert System for the Diagnosis of Hepatobiliary Disease.- Clinical Assessment of a Computer System for Insulin Dosage Adjustment.- A Validation Methodology for Testing Decision-Support Systems for Insulin Dosage Adjustment.- Clinical Value of a Decision Support System for the Assessment of Thyroid Function.- Transferability of Knowledge-Based Systems.- The Role of Diagnostic Uncertainty in Health Care Outcomes and its Potential for Modification with Decision Support.- Fuzzy Set Theory in Medicine.- Decision-Aid Under Uncertainty Based on Separating Power and Fuzzy Measure.- Hyperthyroidism Diagnosis Supporting Using Imprecise Rules.- A Decision Making System in Aviation Medicine.- MEXYS2: A Fuzzy Reasoning Expert System Based on the Subject Emotions Consideration.- Knowledge-Based Fuzzy Classification of Signal Events.- AntibES/Rabat—A Fuzzy Computer-Aided Instruction on the Treatment of Infectious Diseases Designed for Morocco Medical Students and Medical Practitioners.- Expert Systems-Knowledge Models.- Maccord: A Metamodel for Problem Solving Competence Applied to Medicine.- A Clinical Knowledge Model as Basis for Constructing a Decision Supporting System.- Integration of the Causal and Functional Approaches for Robust Medical Diagnosis.- Integrating Closed Form Representations and Qualitative Reasoning for Cancer Treatment.- Signal Processing.- ECG Beat Classification Using Linear Prediction Error Signal.- Averaged Powerspectra of the Electrocardiograms of Patients After Heart Transplantation.- EEG Mapping While Listening to a Text: Differences Between Controls and Schizophrenics.- Fractals in EEG Mapping.- Transputer-Based EMG-Analysis Including Diagnostic Support.- Computerized Cephalometry on Orthodontic Radiographs: Towards Flexible and Easily Customized Systems.- EPEXS: An Expert System for Analysis and Interpretation of Human Evoked Potentials.- An Integrated Computer Workstation for Epilepsy Monitoring: Technical Concept.- The Object-Oriented Approach to the Medical Real Time System Design.- Image Processing.- A Knowledge Base Model for the Interpretation of Radiographic Densities.- Automatic Constructional Analysis of Images in Visuoperceptual Evaluation.- Three Dimensional Reconstruction of a Small Fetal Phantom Using Real-Time Linear Array Ultrasonic Images.- Clustering Algorithms for MRI.- Iterative Image Segmentation via 3-valued Logic for 3-D Display of Medical Data.- Quality Assurance of Reader’s Response in Medical Imaging.- Use of Fractal Dimension in Signal Adaptive Filters for Speckle Reduction in Ultrasound B-Mode Images.- Biometry and Biomathematics.- A Computer Methodology for Reducing the Volume of Oxytocin Used in Labour.- Non-Parametric Regression Techniques for Biometric Problems: Concepts and Software.- Confidence Regions on Optimal Drug or Treatment Combination.- Errors in Estimating the Incidence Due to Left-Truncated Data When Using the Hospital’s Patient Database—A Modelling Approach.- Case Study: Estimation of Drug Effectiveness—Inverse Interpolation of Noisy Data by Nonlinear Least-Squares.- A Cellular Grammar to Model Metabolic Processes.- A Theoretical Study of the Stability of Respiration.- TSOBM: A Tool for the Simulation and Optimization of Biorhythmical Models.- A Non-Linear Model of Insulin Kinetics.- Curricula and Computer-Assisted Education.- Thirteen Years of a Nation-Wide Curriculum in Medical Informatics: Does it Still Meet the Requirements?.- Introducing Medical Informatics as a Horizontal Theme into a Medical School Curriculum.- A New Approach to Computerized Medical Knowledge Assessment.- The Use of the Computer in Gastroenterology for Doctor-Training and Patient-Diagnosis.- Linking Expert-Systems and Interactive Video for Medical Education.- ILIAD: An Expert System for Diagnostic Assistance and Teaching: Implementation in France.- Visualizing Medical Knowledge—An “Intelligent” Textbook Based on Graphical Browsing.- Research and Epidemiology.- EuroHealthDatabase for Hospital Macro and Microcomparisons in Europe: Diabetes Mellitus as an Example.- The Eurohealth Database—Handling Personal Data Without Access to Personal Identification.- ADAMS: Data-Base Management as a Decision Support System for Epidemiologists.- An Integrated System to Support the AIDS Research.- An International Neurology Database Link, Allowing Global Research Queries Across Languages.- An Epidemiological Approach to Computerized Medical Diagnosis: The AEDMI Project, a Multicenter Design to Which Different Artificial Intelligence Systems May Be Gathered.- BIOCELL: An Integrated and Interactive Tool for the Management of Linguistic and Eidetic Biological Data.- The Practical Design and Implementation of Thesauri for Primary Care Information Retrieval Applications.- Investigations of Dependencies in the USSR State Computer Information System “Population Health—Environment”.- Health Care Systems and Services.- Harmonisation of Health Data on the Institutional Level the Case Based Model as a European Approach to Health Care Services Planning and Management.- Information Modelling in the Dutch Health Care.- Executive Information Systems for NHS Senior Management.- A Generic Model of Clinical Practice—The COSMOS Project.- Building a National Health Information System.- HealthPROMPT—A New Initiative in Providing Information for Health Promotion.- An Electronic Patient Information System in Mental Health—An Integrated Solution for Better Care and Management.- Computers in Primary Health Care: The Bhorugram Experience—India.- Computers and Working Conditions in Nursing: Experiences from German Hospitals.- Classification and Coding.- Accuracy of Hospital Diagnostic and Operative Procedure Coding.- GIANO: A Decision Aid to Represent the Semantics of Medical Terms.- Classification Within HIOS+.- The Design and Implementation, Using an Object-Oriented Methodology of a User-Friendly Primary Health Care Patient Management System Based on the ICPC Classification.- CHIC: Community Health Information Classification and Coding.- Aim(ing) for the Record.- The Read Codes and National and International Medical Data Interchange.- Towards a European Classification of Procedures in Medicine (ECPM)—AIM-SESAME and the Dutch and German Approach.- A Multiaxial Model for the Description of Medico-Surgical Procedures.- Quality Assurance and Information Technology.- How to Induce Physicians to Engage in QA Activities in a University Hospital Environment.- Child Health Quality Assurance—A Practical Approach.- Nursing.- C.N.I.S.—Innovation into Practice.- Nomenclature, Coding, Classification, and Standards for Nursing Information Systems.- A Nursing Minimum Data Set in Production.- Computerized Nursing Care Plan.- Nursing Workload Measurement—Computer Support.- Critical Care Nursing Informatics: Promoting the Quality of Life During Crisis.- Wound Care Management.- Health Services Administration.- Identification of Groups of Patients Consuming Equal Resources for a Hospital Financing System by Regression Trees.- Uniform HIS-Cost Modeling: Experiences and First Results for the Leiden University Hospital.- One Approach to Assessing Experience/Price Levels at Hospitals.- Nosocomial Infections and Length of Hospitalization According to DRG.- Appointment Systems—An Information Resource for General Practice.- Standardization.- Inter-Institutional Information Exchange in Healthcare.- EUCLIDES: A European Clinical Laboratory Data Exchange Standard (AIM-Project: A 1033).- Linking Medical Data Standards, Knowledge-Based Systems and the Technique of Partial Evaluation.- Poster Presentations.- Information Systems and Health Care.- A Data Base Management System for an Obstetrics Department.- A Heuristic Approach to a Computerized Database in a Gyneco-Oncologic Outpatient Clinic.- ARZTBRIEF: Generating Medical Reports in a Multimedia Environment.- Whole Blood Aggregometry: A PC-Based System for Clinical Routine Application.- Drug Information Through Online Databases: A Comparison Between External Databases and the In-House Database of a Pharmaceutical Company.- Electronic Transfer of Data for Surveillance of Communicable Disease.- Computer-Aided Cluster Analysis of Citation Networks as a Tool of Research Policy in Biomedicine.- Expert Systems and Decision Making.- Some Aspects of the Implementation of Decision Monitoring Logic within a Heterogeneous Hospital Information System.- Ten Years of Computer Support in a Metabolic Intensive Care Unit.- Application of Rule Induction Algorithm in Medical Research.- A Fuzzy Logical Model of Nutrition Diagnosis.- Artificial Intelligence in Contact Dermatitis: The CODEX/E System.- ARZNEPH: Computer-Assisted Drug Dosage in Renal Failure.- Computer-Assisted Training and Education.- Teaching Electro and Phono Cardiology with Microcomputer.- Computer-Aided Teaching in Neurology.- An AI-Based Training for Nosocomial Infections Control.- Biometry and Biostatistics.- Can Automatic “Scoring” Improve Comparability of Cases and Statistical Results in Emergency Medicine?.- Summary Attributable Risk Estimation in 2 × 2 × K-Tables.- A Comparative Study on Hazard Function Estimators Employing Nearest Neighbour Distances as Bandwidths.- Asymptotic Variance Estimation of Association Measures: A New Approach to Overcome Computational Problems.- Biosignal Processing and Biomedical Engineering.- Intelligent Peripheral Module for Data Acquisition and Control.- A Software to Acquire and to Treat Holter Test Analysed by Pathfinder 3 MK2 Model.- PC-Supported 64-Channel DC-EEG Amplifier.- EEG Probability Mapping While Listening to a Text: A Group and a Single Case Study.- Analysis of Sleep Patterns in Babies Using Neural Networks—Preliminary Results.- Spectral Analysis of Breathing in Infants in the First Year of Life During Quiet Sleep—Preliminary Results.- Electra 800 Data Management Program.- Robotics in Medicine: A Brief Survey.- Demonstrations.- Expert Systems and Decision Making.- Integrated Medical Database and Expert System HEPAXPERT-II: Automatic Interpretation of Tests for Hepatitis A and B.- VARY—The First Expert System for Analysis of Genome Variability.- PEN&PAD; A Multi-Lingual Patient Care Workstation Based on a Unified Representation of the Medical Record and Medical Terminology.- Consultation System for Insulin Dosage Adjustment.- A Metabolic Prototype to Assist in the Management of Insulin-Treated Diabetic Patients.- Computer-Assisted Training and Education.- Computer-Based Clinical Teaching with Multimedia Technology.- Multimedia and Hypertext Programs for Nursing Education.- Information Systems and Health Care.- ARZTBRIEF: Gene...