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Biomedical subjects

W Gall

Publications and source records attributed to W Gall.

At least 19 recordsLinked to original sources
PubMed2004

The strategic approach of managing healthcare data exchange in Austria.

OBJECTIVES: The exchange of electronic medical data between healthcare providers constitutes an integral part of modern medicine, and its importance is growing. Efficient application on a national level requires a uniform approach to the management of healthcare data exchange, avoiding isolated solutions that are expensive and also incompatible. METHODS: In this communication we explain the basic concepts of establishing a nationwide framework to guide healthcare data exchange in Austria. To achieve this goal, a three-step approach was adopted: (i) creating general guidelines to direct electronic medical data exchange; (ii) defining detailed standards for electronic messages; (iii) organizing pilot projects to implement these standards, and further improving the general guidelines based on the results of the pilot projects. RESULTS: We present the MAGDA-LENA framework which guides healthcare data exchange in Austria, and compare it with the US framework HIPAA. We describe several communication scenarios for which concrete message standards were developed in recent years, based on the MAGDA-LENA framework. We further discuss the implementation of these standards in four pilot projects. CONCLUSIONS: The strategic approach of managing healthcare data exchange presented in this paper is expected to have a substantial impact on medical informatics in Austria over the next few years.

Austria↗
PubMed2002

Clinical data retrieval: 25 years of temporal query management at the University of Vienna Medical School.

OBJECTIVES: Today, many clinical information systems include analysis components which allow clinicians to apply a selection of predefined statistical functions that satisfy typical cases. They are mostly to inflexible to handle complex, non-standard problems, however. The focus of this paper, therefore, is to present an approach that enables clinicians to autonomously create ad hoc queries including temporal relations in an interactive environment. METHODS: We developed the query language AMAS, which was specifically customized for users from the medical domain to flexibly retrieve and interpret temporal, clinical data. AMAS provides for a significant temporal expressiveness in data retrieval using time-stamped clinical databases and relies on an operator-operand concept for the specification of a query. RESULTS: Within the last 25 years, four different clinical retrieval systems have been implemented at the Department of Medical Computer Sciences, based on the AMAS query language. Currently, these systems allow access to the medical records of more than 2 million patients. Physicians of 46 different departments at the University of Vienna and Graz Medical Schools have made extensive use of these systems in the course of clinical research and patient care, executing more than 10,000 queries per year. CONCLUSIONS: We discuss a list of 20 issues that represent the most essential lessons we have learned in the development of the four systems mentioned above. Amongst others, our experiences indicate that the operator-operand concept allows on intuitive specification of complex, temporal queries. Further, customization to different user classes, based on their statistical background, is essential.

Austria↗
PubMed2001

Extracting a statistical data matrix from electronic patient records.

This paper describes the processing and transformation of medical data from a clinical database to a statistical data matrix. Precise extraction and linking tools must be available for the desired data to be processed for statistical purposes. We show that flexible mechanisms are required for the different types of users, such as physicians and statisticians. In our retrieval tools we use logical queries based on operands and operators. The paper describes the method and appliance of the operators with which the desired matrix is created through a process of selection and linking. Examples with a Kaplan-Meier function and time-dependent covariables demonstrate how our model is useful for different user groups.

Biometry↗
PubMed2001

Moving time window aggregates over patient histories.

Moving window concepts are used in temporal query languages for aggregate functions over the dimension 'time'. In the medical domain, aggregation of patient data over time windows builds a powerful mechanism within clinical database queries to satisfy a class of typical medical question formulations. Contrary to other fields, like the business domain for example, there is the additional need to synchronize time windows with the individual course of diseases rather than with the calendar system only. In this paper, we present several variants of shifting time windows over patient histories and suggest a set of essential options for a moving window clause. The proposed parameters for window creation as well as suitable default settings are discussed in the context of retrieving data from medical records.

Databases as Topic↗
PubMed2001

Retrieval-oriented design of clinical research forms.

Computerized clinical forms are subject to a wide variety of different requirements. They have to allow detailed documentation and must be user-friendly. State-of-the-art applications for design permit clinicians themselves to create their own forms as needed, with the various variables presented in different ways depending on their intended use. Often, however, only aspects of clinical documentation are considered, with no thought being given to subsequent data retrieval. This article presents guidelines for the retrieval-oriented design of clinical forms. It discusses where anticipatory measures for structuring forms are easier to accomplish than complex data linkage at the time of retrieval and analysis.

Austria↗
PubMed2000

Unambiguous identification of hospital patients: case study at the university departments of the General Hospital, Vienna.

This article considers the problem of identifying patients in one or more heterogeneous personal databases. The unambiguous identification of patients is an essential prerequisite for an efficient patient care system. We discuss the problems involved in this task and suggest how they can be dealt with. The solution of automatic consolidation of patient records sequires programming, organisational and work psychology measures. Following a survey of conventional identification methods, the method developed at the Department of Medical Computer Sciences, which is based on the current clinical situation at the General Hospital in Vienna (AKH--Allgemeines KrankenHaus), is described in detail. The basic principle is to identify patients unambiguously by means of an ID (IZAHL) derived directly from the personal data. Thereby a deterministic technique without probability weighting is used-all compared information must correspond completely. The article closes with a critical survey of experience gathered to date.

Algorithms↗
PubMed1999

ArchiMed: a medical information and retrieval system.

ArchiMed is a highly flexible medical data storage and retrieval system which adds sophisticated clinical research support to a standard hospital information system (HIS). Currently, the HIS of Vienna General Hospital-University Hospital (2000 beds) stores the clinical data of over 2 million patients. While this system supports patient care (e.g., ADT, clinical chemistry, diagnosis, procedures), it has no features to facilitate research, such as the management of clinical studies. ArchiMed is designed to support clinical research. It includes an independent database, which mirrors virtually all the information held in the HIS while also allowing new data to be collected independently and to be added to the database. Flexible retrieval and analysis of data contained in the database are then possible. Thus, existing patient data can be smoothly incorporated into a study together with data collected specifically for research purposes. The system has already been successfully installed in the departments of surgery and soon in other departments as well.

Austria↗
PubMed1987

Thrombolytic therapy of axillary-subclavian venous thrombosis.

Patients with axillary-subclavian vein thrombosis often have a poor outcome when treated with intravenous heparin sodium and oral warfarin sodium. Four patients were therefore treated with thrombolytic therapy. Good initial and excellent long-term results were achieved. In follow-up that has ranged up to four years, these patients do not have the common complaints of edema, fatigue, cramping, or weakness seen after traditional anticoagulation. Patients have returned to their previous occupations and have normal arm function. Noninvasive Doppler vascular laboratory studies suggest continued patency of axillary veins. Thrombolytic therapy should be considered in the treatment of spontaneous axillary-subclavian vein thrombosis.

Adult↗
PubMed1987

Comparative anti-influenza vaccination of some groups of the population with vaccines differing in virus purification level.

A total of 1215 persons, divided into 4 groups, were immunized with influenza vaccines A (highly purified, whole-virion), B (subunit, containing H and M), and C (conventional, commercial partly purified by Sharplers centrifugation). Post-vaccination reactions were followed, and serological tests (HI and NI) were performed with serum specimens taken from each vaccine 4 times during and after the vaccination period. The results point to clear superiority of purified and subunit vaccines over the conventional one.

Antibodies, Viral↗
PubMed1979

[Tracheal stenosis (author's transl)].

13 cases of stenosis of the trachea are reported and its causes are reviewed. The main causal factors are malignant and benign growths, but chronic granulating tracheitis consequent on prolonged artificial ventilation also plays a role. The extent of the stenosis necessitated partial resection of the trachea in 9 patients. Problems attendant on the operation are reviewed with special reference to after-treatment. In cases of inoperable cancer with tracheal narrowing endoscopic removal of tumour tissue may be life-prolonging measure.

Aftercare↗