Biomedical subjects

Der-Ming Liou

Publications and source records attributed to Der-Ming Liou.

7 recordsLinked to original sources

PubMed2005

Health information system for community-based multiple screening in Keelung, Taiwan (Keelung Community-based Integrated Screening No. 3).

BACKGROUND: Community-based multiple screening for common cancers and chronic diseases has increasingly gained attention. However, as infrastructure and evaluation system are more diversified and complicated compared with single screening, the development of a novel health information system is paramount. METHODS: The main goal of our health information system was to support the multiple screening program not only from technical aspect but also from a broad range of perspectives including quality assurance system, organized features appertaining to screening, economic evaluation (cost-effectiveness or cost-utility analysis), epidemiological applications, behavior risk factor surveillance system, and social impact due to the introduction of the Keelung Community-Based Integrated Screening (KCIS) program. RESULTS: Health information system was designed and programmed on the basis of the demand derived from KCIS within which five cancers and three chronic diseases were included. In addition to the detailed description of infrastructure and process, design, relevant database and security involved in health information system, an innovative and extensive evaluation system in accordance with the main goals was included in our health information system. CONCLUSION: Our information system proposed several aspects regarding organized screening system that has never been addressed in computerized system supporting for single screening. These included quality assurance system, organization features, co-morbidity profiles, epidemiological applications and social and economic considerations.

Community Health Services↗

PubMed2005

Development of a deterministic XML schema by resolving structure ambiguity of HL7 messages.

Health level 7 (HL7) is a standard for medical information exchange. It defines data transfers for the application systems in the healthcare environment. Alternatively, the extensible markup language (XML) is a standard for data exchange using the Internet. If exchange messages follow the content and the sequence defined by HL7 and are expressed in the XML format, the system may benefit from the advantages of both standards. In creating the XML schema, we found ambiguities in HL7 message structures that cause the XML schema to be non-deterministic. These ambiguous expressions are summarized within 12 structures and can be replaced with equivalent or similar unambiguous structures. The finite state automata are used to verify expression equivalence. Applying this schema, an XML document may eliminate redundant segment group definitions and make the structure simple and easy to reproduce. In this paper, we discuss the methods and our experience in resolving ambiguous problems in HL7 messages to generate a deterministic XML schema.

Health Status↗

PubMed2005

Computer-aided disease prediction system: development of application software with SAS component language.

AIMS: The intricacy of predictive models associated with prognosis and risk classification of disease often discourages medical personnel who are interested in this field. The aim of this study was therefore to develop a computer-aided disease prediction model underpinning a step-by-step statistics-guided approach including five components: (1) data management; (2) exploratory analysis; (3) type of predictive model; (4) model verification; (5) interactive mode of disease prediction using SAS 8.02 Windows 2000 as a platform. METHODS: The application of this system was illustrated by using data from the Swedish Two-County Trial on breast cancer screening. The effects of tumour size, node status, and histological grade on breast cancer death using logistic regression model or survival models were predicted. A total of 20 questions were designed to exemplify the usefulness of each component. We also evaluated the system using a controlled randomized trial. Times to finish the above 20 questions were used as endpoint to evaluate the performance of the current system. User satisfaction with the current system such as easy to use, the efficiency of risk prediction, and the reduction of barrier to predictive model was also evaluated. RESULTS: The intervention group not only performed more efficiently than the control group but also satisfied with this application software. CONCLUSIONS: The MD-DP-SOS system characterized by menu-driven style, comprehensiveness, accuracy and adequacy assessment, and interactive mode of disease prediction is helpful for medical personnel who are involved in disease prediction.

Decision Support Techniques↗

PubMed2005

Predictive survival model with time-dependent prognostic factors: development of computer-aided SAS Macro program.

AIMS AND OBJECTIVES: Computer program for the prediction of survival with respect to time-dependent proportional hazards regression model has been rarely addressed. We therefore developed a SAS Macro program for time-dependent Cox regression predictive model for empirical survival data associated with time-dependent covariates. METHOD: Time-dependent proportional hazards regression model and partial likelihood in association with time-varying predictors were explicitly delineated. Baseline hazard using Andersen's method was incorporated into proportional hazards regression model to predict the dynamic change of cumulative survival in respect of time-varying predictors. Two SAS Macro programs for time-dependent predictive survival model and model validation using receiver operative characteristics were written with SAS IML language. RESULTS: The computer program was applied to data on clinical surveillance of small hepatocellular carcinoma (HCC) treated by percutaneous ethanol injection (PEI) or transcatheter arterial embolization (TAE) with time-varying predictors such as alpha-feto protein (AFP) and other biological markers. CONCLUSION: The program is very useful for real-time prediction of cumulative survival on the basis of time-dependent covariates.

Carcinoma, Hepatocellular↗

PubMed2004

Bio-Mirror project for public bio-data distribution.

Timely worldwide distribution of biosequence and bioinformatics data depends on high performance networking and advances in Internet transport methods. The Bio-Mirror project focuses on providing up-to-date distribution of this rapidly growing and changing data. It offers FTP, Web and Rsync access to many high-volume databanks from several sites around the world. Experiments with data grids and other methods offer future improvements in biology data distribution.

Biology↗

PubMed2004

Feasibility of tele-ophthalmology for screening for eye disease in remote communities.

We assessed the feasibility of tele-ophthalmology in a remote location, Tungyin, an island 200 km from Taiwan, which has no ophthalmologist. Screening for eye diseases was carried out among residents aged 40 years or more. A total of 113 subjects, approximately 31% of the whole population, were enrolled in the screening programme. Images were transmitted (via ADSL) to a retinal specialist in Taiwan for diagnosis. The average processing time, excluding the time for copying files, was 6.4 s (SD 2.1) per subject. Transmission took 60-90 s for most of the images (83%). The average time required to make a diagnosis for each subject, including data entry, was approximately 34 s (SD 18). In screening for retinopathy, the detection rate with digital imaging (8.8%) was two times higher than with indirect ophthalmoscopy (4.4%). In 12% of cases macular degeneration was identified, and in 6% there were mild or moderate problems with the optic disc. Community-based screening for four categories of eye disease was successfully demonstrated using store-and-forward tele-ophthalmology.

Adult↗

PubMed2003

Design and implementation of a web-based HL7 message generation and validation system.

Health level 7 (HL7) is the standard of electronic data interchange in the health domain. We have developed a web-based message generation and validation system for testing the message format of the data exchange among hospitals and health organizations. Compared with other existing ones, this system has incorporated several novel functions that optimize medical data exchange and helps medical students in learning HL7 messages. When receiving HL7 message from another system with the hypertext transmission protocol or accepting an uploaded HL7 message file, the system shows the validation result through a web browser. In this platform, users may input and edit medical data on-line to test and generate standard HL7 messages. The system supports various data formats and is capable of transforming HL7 messages between the standard delimiter format and the extensible markup language format. This system has been successfully passed our system evaluation among 139 student users for HL7 training. Most of the users agreed that the system is helpful for medical data exchange.

Computer Systems↗