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Medical logic module

Stefan Kraus
The Arden Syntax for Medical Logic Systems is a standard for encoding and sharing knowledge in the form of Medical Logic Modules (MLMs). Although the Arden Syntax has been designed to meet the requirements of data-driven clinical event monitoring, multiple studies suggest that its language constructs may be suitable for use outside the intended application area and even as a common clinical application language. Such a broader context, however, requires to reconsider some language features. The purpose of this paper is to outline the related modifications on the basis of a generalized Arden Syntax version...
2018: Studies in Health Technology and Informatics
Don V Byars, Jordan Tozer, John M Joyce, Michael J Vitto, Lindsay Taylor, Turan Kayagil, Matt Jones, Matthew Bishop, Barry Knapp, David Evans
INTRODUCTION: Transesophageal echocardiography (TEE) is a well-established method of evaluating cardiac pathology. It has many advantages over transthoracic echocardiography (TTE), including the ability to image the heart during active cardiopulmonary resuscitation. This prospective simulation study aims to evaluate the ability of emergency medicine (EM) residents to learn TEE image acquisition techniques and demonstrate those techniques to identify common pathologic causes of cardiac arrest...
August 2017: Western Journal of Emergency Medicine
Taqdir Ali, Maqbool Hussain, Wajahat Ali Khan, Muhammad Afzal, Jamil Hussain, Rahman Ali, Waseem Hassan, Arif Jamshed, Byeong Ho Kang, Sungyoung Lee
OBJECTIVE: Technologically integrated healthcare environments can be realized if physicians are encouraged to use smart systems for the creation and sharing of knowledge used in clinical decision support systems (CDSS). While CDSSs are heading toward smart environments, they lack support for abstraction of technology-oriented knowledge from physicians. Therefore, abstraction in the form of a user-friendly and flexible authoring environment is required in order for physicians to create shareable and interoperable knowledge for CDSS workflows...
October 2017: Computer Methods and Programs in Biomedicine
Conan MacDougall, Brian S Schwartz, Lisa Kim, Mari Nanamori, Sharmin Shekarchian, Peter V Chin-Hong
BACKGROUND: Inappropriate antimicrobial use can threaten patient safety and is the focus of collaborative physician and pharmacist antimicrobial stewardship teams. However, antimicrobial stewardship is not comprehensively taught in medical or pharmacy school curricula. Addressing this deficiency can teach an important concept as well as model interprofessional healthcare. METHODS: We created an antimicrobial stewardship curriculum consisting of an online learning module and workshop session that combined medical and pharmacy students, with faculty from both professions...
2017: Open Forum Infectious Diseases
Yongjun Liang, Bo Yu, Yueqian Wang, Zhengdong Qiao, Ting Cao, Peng Zhang
BACKGROUND: The duodenum plays a role in the mechanism of type 2 diabetes remission after bariatric surgery. Roux-en-Y gastric bypass (RYGB) may change gene expression in the duodenum and metabolism. Long noncoding RNAs (lncRNAs) constitute a novel class of RNAs that regulate gene expression. Little is known about how duodenal lncRNAs respond to RYGB. Logically, studies on the changes of duodenal lncRNAs potentially can lead to an understanding of the mechanisms of bariatric surgery, as well as discovery of antidiabetic drug targets and biomarkers predicting postoperative outcome...
July 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Ole Haagen Nielsen, Yuan Li, Bengt Johansson-Lindbom, Mehmet Coskun
An unmet medical need exists for the development of targeted therapies for the treatment of inflammatory bowel disease (IBD) with easily administered and stable oral drugs, particularly as most patients on biologics [i.e., tumor necrosis factor (TNF) inhibitors and anti-integrins] are either primary non-responders or lose responsiveness during maintenance treatment. A new class of small molecules, sphingosine-1-phosphate (S1P) receptor modulators, has recently shown efficacy in IBD. Here we provide an overview of the mechanism of action of this novel treatment principle in the context of intestinal inflammation...
April 2017: Trends in Molecular Medicine
Klaus-Hendrik Wolf, Mike Klimek
The Arden Syntax for Medical Logic Modules is a standardized and well-established programming language to represent medical knowledge. To test the compliance level of existing compilers and interpreters no public test suite exists. This paper presents the research to transform the specification into a set of unit tests, represented in JUnit. It further reports on the utilization of the test suite testing four different Arden Syntax processors. The presented and compared results reveal the status conformance of the tested processors...
2016: Studies in Health Technology and Informatics
Pananghat Achutha Kumar, Ramakrishnan Jothi, Dharmalingam Mathivanan
BACKGROUND: A contemporary anatomy curriculum that aims to be clinically relevant requires medical students to be introduced to radiological anatomy in the preclinical years. Ideally, the curriculum should also support self-directed learning, a habit best instilled early. Based on these educational requirements, we designed an interesting and clinically-meaningful program of self-learning modules in radiological anatomy to augment students' learning of gross anatomy. The program is guided by current theories of learning, which emphasize an individualized learning pace for students...
May 2016: Education for Health: Change in Training & Practice
Chai Young Jung, Jong-Ye Choi, Seong Jik Jeong, Kyunghee Cho, Yong Duk Koo, Jin Hee Bae, Sukil Kim
INTRODUCTION: Arden Syntax is a Health Level Seven International (HL7) standard language that is used for representing medical knowledge as logic statements. Arden Syntax Markup Language (ArdenML) is a new representation of Arden Syntax based on XML. Compilers are required to execute medical logic modules (MLMs) in the hospital environment. However, ArdenML may also replace the compiler. The purpose of this study is to demonstrate that MLMs, encoded in ArdenML, can be transformed into a commercial rule engine format through an XSLT stylesheet and made executable in a target system...
May 16, 2016: Artificial Intelligence in Medicine
Christoph Mitsch, Karsten Fehre, Sonja Prager, Christoph Scholda, Katharina Kriechbaum, Thomas Wrba, Ursula Schmidt-Erfurth
The management of diabetic retinopathy, a frequent ophthalmological manifestation of diabetes mellitus, consists of regular examinations and a standardized, manual classification of disease severity, which is used to recommend re-examination intervals. To evaluate the feasibility and safety of implementing automated, guideline-based diabetic retinopathy (DR) grading into clinical routine by applying established clinical decision support (CDS) technology. We compared manual with automated classification that was generated using medical documentation and an Arden server with a specific medical logic module...
2016: Studies in Health Technology and Informatics
Ricardo Salas-Flores, Brian González-Pérez
BACKGROUND: Medical internship is an important period in the formation of a general (or medical) practitioner, in which the student becomes a member of the "health community" and also applies all the knowledge he or she has received during the university lectures. The present study aims to evaluate the impact of the implementation of the academic day programme designed for undergraduate medical interns within the Mexican second level healthcare Hospital General Regional No. 6 "Dr...
May 2016: Revista Médica del Instituto Mexicano del Seguro Social
J Isakova
BACKGROUND: Rapid development of medicine requires regular update of clinical data evidence. This task accomplishment requires participation of numerous specialists in evidence-based medicine, who are proficient in various statistical methods and can work with big data analysis tools in biomedical sciences. This, in turn, requires significant time and other resources. Today, at the peak of IT development, cognitive systems in the field of medicine with special technologies of data collection and analysis, is the start of a new trend...
2015: International Journal of Risk & Safety in Medicine
Stefan Kraus, Caroline Drescher, Martin Sedlmayr, Ixchel Castellanos, Hans-Ulrich Prokosch, Dennis Toddenroth
OBJECTIVE: Most practically deployed Arden-Syntax-based clinical decision support (CDS) modules process data from individual patients. The specification of Arden Syntax, however, would in principle also support multi-patient CDS. The patient data management system (PDMS) at our local intensive care units does not natively support patient overviews from customizable CDS routines, but local physicians indicated a demand for multi-patient tabular overviews of important clinical parameters such as key laboratory measurements...
October 9, 2015: Artificial Intelligence in Medicine
Maqbool Hussain, Muhammad Afzal, Taqdir Ali, Rahman Ali, Wajahat Ali Khan, Arif Jamshed, Sungyoung Lee, Byeong Ho Kang, Khalid Latif
OBJECTIVE: The objective of this study is to help a team of physicians and knowledge engineers acquire clinical knowledge from existing practices datasets for treatment of head and neck cancer, to validate the knowledge against published guidelines, to create refined rules, and to incorporate these rules into clinical workflow for clinical decision support. METHODS AND MATERIALS: A team of physicians (clinical domain experts) and knowledge engineers adapt an approach for modeling existing treatment practices into final executable clinical models...
October 28, 2015: Artificial Intelligence in Medicine
Jeroen S de Bruin, Christian Schuh, Walter Seeling, Eva Luger, Michaela Gall, Elisabeth Hütterer, Gabriela Kornek, Bernhard Ludvik, Friedrich Hoppichler, Karin Schindler
BACKGROUND: Nutritional screening procedures followed by regular nutrition monitoring for oncological outpatients are no standard practice in many European hospital wards and outpatient settings. As a result, early signs of malnutrition are missed and nutritional treatment is initiated when patients have already experienced severe weight loss. OBJECTIVE: We report on a novel clinical decision support system (CDSS) for the global assessment and nutritional triage of the nutritional condition of oncology outpatients...
October 22, 2015: Artificial Intelligence in Medicine
Alán Alpár, Vincenzo Di Marzo, Tibor Harkany
Endocannabinoids regulate brain development via modulating neural proliferation, migration, and the differentiation of lineage-committed cells. In the fetal nervous system, (endo)cannabinoid-sensing receptors and the enzymatic machinery of endocannabinoid metabolism exhibit a cellular distribution map different from that in the adult, implying distinct functions. Notably, cannabinoid receptors serve as molecular targets for the psychotropic plant-derived cannabis constituent Δ(9)-tetrahydrocannainol, as well as synthetic derivatives (designer drugs)...
April 1, 2016: Biological Psychiatry
Vibha Anand, Aaron E Carroll, Paul G Biondich, Tamara M Dugan, Stephen M Downs
BACKGROUND: Pediatric guidelines based care is often overlooked because of the constraints of a typical office visit and the sheer number of guidelines that may exist for a patient's visit. In response to this problem, in 2004 we developed a pediatric computer based clinical decision support system using Arden Syntax medical logic modules (MLM). METHODS: The Child Health Improvement through Computer Automation system (CHICA) screens patient families in the waiting room and alerts the physician in the exam room...
October 1, 2015: Artificial Intelligence in Medicine
Ixchel Castellanos, Stefan Kraus, Dennis Toddenroth, Hans-Ulrich Prokosch, Thomas Bürkle
OBJECTIVE: Bacterial infections frequently cause prolonged intensive care unit (ICU) stays. Repeated measurements of the procalcitonin (PCT) biomarker are typically used for early detection and follow up of bacterial infections and sepsis, but those PCT measurements are costly. To avoid overutilization, we developed and evaluated a clinical decision support system (CDSS) in Arden Syntax which computes necessary and preventable PCT orders. METHODS: The CDSS implements a rule set based on the latest PCT value, the time period since this measurement, and the PCT trend scenario...
September 25, 2015: Artificial Intelligence in Medicine
Stefan Kraus, Martin Enders, Hans-Ulrich Prokosch, Ixchel Castellanos, Richard Lenz, Martin Sedlmayr
OBJECTIVE: Arden Syntax is a standard for representing and sharing medical knowledge in form of independent modules and looks back on a history of 25 years. Its traditional field of application is the monitoring of clinical events such as generating an alert in case of occurrence of a critical laboratory result. Arden Syntax Medical Logic Modules must be able to retrieve patient data from the electronic medical record in order to enable automated decision making. For patient data with a simple structure, for instance a list of laboratory results, or, in a broader view, any patient data with a list or table structure, this mapping process is straightforward...
September 12, 2015: Artificial Intelligence in Medicine
X Chang, D Yang
PURPOSE: A software tool was developed in this study to perform automatic weekly physics chart check on the patient data in ARIA. The tool accesses the electronic patient data directly from ARIA server and checks the accuracy of treatment deliveries, and generates reports which summarize the delivery history and highlight the errors. METHODS: The tool has four modules. 1) The database interface is designed to directly access treatment delivery data from the ARIA database before reorganizing the data into the patient chart tree (PCT)...
June 2015: Medical Physics
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