Studies in Health Technology and Informatics, 2022
For medical informaticians, it became more and more crucial to assess the benefits and disadvanta... more For medical informaticians, it became more and more crucial to assess the benefits and disadvantages of AI-based solutions as promising alternatives for many traditional tools. Besides quantitative criteria such as accuracy and processing time, healthcare providers are often interested in qualitative explanations of the solutions. Explainable AI provides methods and tools, which are interpretable enough that it affords different stakeholders a qualitative understanding of its solutions. Its main purpose is to provide insights into the black-box mechanism of machine learning programs. Our goal here is to advance the problem of qualitatively assessing AI from the perspective of medical informaticians by providing insights into the central notions, namely: explainability, interpretability, understanding, trust, and confidence.
Studies in health technology and informatics, 2021
Ontologies promise more benefits than terminologies in terms of data annotation and computer-assi... more Ontologies promise more benefits than terminologies in terms of data annotation and computer-assisted reasoning, by defining a hierarchy of terms and their relations within a domain. Here, we present central insights related to the development of an ontology for documenting events during interoperative neuromonitoring (IOM), for which we used the Basic Formal Ontology (BFO) as an upper-level ontology. This work has the following two goals: to describe the development of the IOM ontology and to guide the practice with respect to documenting of biomedical events, as available ontologies pose difficulties on certain issues. We address the following issues: (i) differentiate between the sets documentation, identification, continuant and explanation, understanding, occurrent as we had problems in applying the available ontology of adverse events, (ii) covering diseases and injuries in a consistent way, and (iii) deciding on which level to define relations.
Studies in Health Technology and Informatics, 2022
For guiding decisions on medical diagnoses and diagnoses, it is crucial to receive valid laborato... more For guiding decisions on medical diagnoses and diagnoses, it is crucial to receive valid laboratory test results. However, such results can be implausible for the physician, even if the measurements are within the range of known reference values. There are technical sources of implausible results that are related to the laboratory environment, which are frequently not detected through usual measures for ensuring technical validity. Here, we describe the development of a quality assurance tool that tackles this problem and replaces the current manual statistical analyses at the Center for Laboratory Medicine in St Gallen (ZLM). Further analysis of the factors responsible for shifts in laboratory test results requires to collect and analyze data related to reagents as well as calibration or reference probes. Due to a lack of standard operating procedures in many laboratories with respect to these processes, this remains one of the big challenges.
Studies in Health Technology and Informatics, 2022
Especially in biomedical research, individual-level data must be protected due to the sensitivity... more Especially in biomedical research, individual-level data must be protected due to the sensitivity of the data that is associated with patients. The broad goal of scientific data re-use is to allow many researchers to derive new hypotheses and insights from the data while preserving privacy. Data usage control (DUC) as an attribute-based access mechanism promises to overcome the limitations of traditional access control models achieving that goal. Park and Sandhu provided the usage control (UCON) model as an instance of DUC, which defines policies that evaluate certain attributes. Here, we present an UCON-based architecture, which is augmented with risk-based anonymization as provided by the R package sdcMicro and an extensible Access Control Markup Language (XACML) environment with a core policy decision point as implemented by authzforce.
Studies in health technology and informatics, 2018
A precise and timely care delivery depends on an efficient triage performed by primary care provi... more A precise and timely care delivery depends on an efficient triage performed by primary care providers and smooth collaboration with other medical specialities. In recent years telemedicine gained increasing importance for efficient care delivery. It's use, however, has been limited by legal issues, missing digital infrastructures, restricted support from health insurances and the digital divide in the population. A new era towards eHealth and telemedicine starts with the establishment of national eHealth regulations and laws. In Switzerland, a nation-wide digital infrastructure and electronic health record will be established. But appropriate healthcare apps to improve patient care based on this infrastructure remain rare. In this paper, we present two applications (self-anamnesis and eMedication assistant) for eHealth enabled care delivery which have the potential to speed up diagnosis and treatment.
Studies in health technology and informatics, 2020
Next generation sequencing (NGS) technologies allow improved understanding of pathogens. In the u... more Next generation sequencing (NGS) technologies allow improved understanding of pathogens. In the upstream processing of generating genomic data, there is still a lack of process-oriented tools for managing corresponding meta data. In this paper, we provide a description of how a process-oriented software prototype was developed that allowed the capture and collation of metadata involved when doing NGS. Our question was: How to develop an interactive web application that supports the process-oriented management of genetic data independent of any sequencing technique?
Studies in Health Technology and Informatics, 2022
For medical informaticians, it became more and more crucial to assess the benefits and disadvanta... more For medical informaticians, it became more and more crucial to assess the benefits and disadvantages of AI-based solutions as promising alternatives for many traditional tools. Besides quantitative criteria such as accuracy and processing time, healthcare providers are often interested in qualitative explanations of the solutions. Explainable AI provides methods and tools, which are interpretable enough that it affords different stakeholders a qualitative understanding of its solutions. Its main purpose is to provide insights into the black-box mechanism of machine learning programs. Our goal here is to advance the problem of qualitatively assessing AI from the perspective of medical informaticians by providing insights into the central notions, namely: explainability, interpretability, understanding, trust, and confidence.
Studies in health technology and informatics, 2021
Ontologies promise more benefits than terminologies in terms of data annotation and computer-assi... more Ontologies promise more benefits than terminologies in terms of data annotation and computer-assisted reasoning, by defining a hierarchy of terms and their relations within a domain. Here, we present central insights related to the development of an ontology for documenting events during interoperative neuromonitoring (IOM), for which we used the Basic Formal Ontology (BFO) as an upper-level ontology. This work has the following two goals: to describe the development of the IOM ontology and to guide the practice with respect to documenting of biomedical events, as available ontologies pose difficulties on certain issues. We address the following issues: (i) differentiate between the sets documentation, identification, continuant and explanation, understanding, occurrent as we had problems in applying the available ontology of adverse events, (ii) covering diseases and injuries in a consistent way, and (iii) deciding on which level to define relations.
Studies in Health Technology and Informatics, 2022
For guiding decisions on medical diagnoses and diagnoses, it is crucial to receive valid laborato... more For guiding decisions on medical diagnoses and diagnoses, it is crucial to receive valid laboratory test results. However, such results can be implausible for the physician, even if the measurements are within the range of known reference values. There are technical sources of implausible results that are related to the laboratory environment, which are frequently not detected through usual measures for ensuring technical validity. Here, we describe the development of a quality assurance tool that tackles this problem and replaces the current manual statistical analyses at the Center for Laboratory Medicine in St Gallen (ZLM). Further analysis of the factors responsible for shifts in laboratory test results requires to collect and analyze data related to reagents as well as calibration or reference probes. Due to a lack of standard operating procedures in many laboratories with respect to these processes, this remains one of the big challenges.
Studies in Health Technology and Informatics, 2022
Especially in biomedical research, individual-level data must be protected due to the sensitivity... more Especially in biomedical research, individual-level data must be protected due to the sensitivity of the data that is associated with patients. The broad goal of scientific data re-use is to allow many researchers to derive new hypotheses and insights from the data while preserving privacy. Data usage control (DUC) as an attribute-based access mechanism promises to overcome the limitations of traditional access control models achieving that goal. Park and Sandhu provided the usage control (UCON) model as an instance of DUC, which defines policies that evaluate certain attributes. Here, we present an UCON-based architecture, which is augmented with risk-based anonymization as provided by the R package sdcMicro and an extensible Access Control Markup Language (XACML) environment with a core policy decision point as implemented by authzforce.
Studies in health technology and informatics, 2018
A precise and timely care delivery depends on an efficient triage performed by primary care provi... more A precise and timely care delivery depends on an efficient triage performed by primary care providers and smooth collaboration with other medical specialities. In recent years telemedicine gained increasing importance for efficient care delivery. It's use, however, has been limited by legal issues, missing digital infrastructures, restricted support from health insurances and the digital divide in the population. A new era towards eHealth and telemedicine starts with the establishment of national eHealth regulations and laws. In Switzerland, a nation-wide digital infrastructure and electronic health record will be established. But appropriate healthcare apps to improve patient care based on this infrastructure remain rare. In this paper, we present two applications (self-anamnesis and eMedication assistant) for eHealth enabled care delivery which have the potential to speed up diagnosis and treatment.
Studies in health technology and informatics, 2020
Next generation sequencing (NGS) technologies allow improved understanding of pathogens. In the u... more Next generation sequencing (NGS) technologies allow improved understanding of pathogens. In the upstream processing of generating genomic data, there is still a lack of process-oriented tools for managing corresponding meta data. In this paper, we provide a description of how a process-oriented software prototype was developed that allowed the capture and collation of metadata involved when doing NGS. Our question was: How to develop an interactive web application that supports the process-oriented management of genetic data independent of any sequencing technique?
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Papers by Jürgen Holm