Health Informatics Assignment Week 7 to 9

Week 7 Question

1. What are the five possible approaches to accelerating the creation of standards?
2. Define five health care standards, not mentioned in the chapter, that might also be needed?
   

   Answer:

   The five standards of care that are not included in the chapter but are important:

   CDA-HL7-

   Clinical Document Architecture – provides an evolutionary approach (XML-based) for clinical documents (like discharge instructions or even treatment plans); lately recognized as Architecture of Patient Records (PRA).

   LIONC-

   Logical Observation Identifiers Names and codes – add common code names and identifiers to Electronic Health Record scientific terms or facilitate in the electronic sharing and processing of diagnostic criteria (like laboratory studies, clinical evaluations, outcomes tracking, and study).

   ELINCS-

   EHR-Lab Interoperability and Connectivity Standards -an evolving framework for recording findings from laboratory research.

   CCHIT-

   Certification Commission for Healthcare Information Technology -serves as the identified US certification authority for EHR and its channels. In September 2005, the US granted CCHIT a three-year deal. Health and Human Services Department to establish and assess the accreditation requirements and inspection process besides EHRs and the platforms whereby they interface.

   HITSP-

   Healthcare Information Technology Standards Panel- Healthcare Information Technology Standards Panel – succeeds in ensuring generally acknowledged and quickly adopted consensus-based requirements which would allow and foster wide-ranging compatibility amongst health information technology, particularly although they would communicate in a United States-based NHIN.

3. What role should the government play in the creation of standards?
4. At what level might a standard interfere with a vendor’s ability to produce a unique product?
   

   Answer:

   A standard might interfere with the ability of the vendor in producing a unique product is at the certification level. The usage of the products is increased when the product tends to be certified. And manage outcomes. The use of most specifications is improved by a validation process under which an impartial entity certifies that maybe a vendor 's product both complies with the standard and complies with it. It helps to devise a purchasing plan for a category of products or services or individual selection, and the background to establish the criteria. Knowing the marketplaces may also impact the way a demand is organized. All respondents would know the general issues but have had their own patented approach to addressing the others. Interpretations of fundamental concepts that are ordinarily overlooked, including what comprises a test or eventually lead, should be explicitly indicated or consented upon. The position of the retailer has been included in the draft standard in drafting is generally the work of certain committed individuals who traditionally portray the vendors within this sector. That draft is instead reviewed by several other individuals; contentious points are thoroughly discussed while alternatives are recommended as well as fully acknowledged. In particular, a standard could go through many iterations itself on journey towards aturation. The first attempts at incorporation are often met with disappointment as engaging vendors perceive the standard widely and as regions are found which are not covered by the specification. Later updates of the standard can address these issues. The very first approaches at incorporation are often met with disappointment as engaging vendors perceive the specification widely and as regions are found that are not covered by the specification. Later updates of the specification can address these issues. In the end, certain kind of following traits is required to ensure vendors conform to the specification and maintain its reputation. Development of a norm is an effective time- and money-saving process. Vendors and customers must've been able to pay the multiple hours of service, typically in terms of organizational time; insurance costs; and paperwork and distribution costs.

5. Define a hypothetical standard for one of the areas mentioned in the text for which no current standard exists. Include the conceptualization and discussion points. Specifically state the scope of the standard.

Week 8 Question

Questions for Discussion

1. Develop a regular expression to regularize the tokens in lines 4–9 of the cardiaccatheterization report shown in Figure 8.7 (Complications through Heart Rate).
2. Create a lexicon for the last seven lines of the cardiac catheterization report shown in Figure 8.7 (Conclusions through the last sentence). For each word, determine all the parts of speech that apply, using the tags in Table 8.2. Which words have more than one part of speech? Choose eight clinically relevant words in that section of the report, and suggest appropriate semantic categories for them that would be consistent with the SNOMED axes and with the UMLS semantic network.
3. Using the grammar in Figure 8.3, draw all possible parse trees for each of the sample sentences 1a, 2a, and 3a discussed in Section 8.4.3. For each sentence, indicate which parse represents the correct structure.
4. Using the grammar in Figure 8.3, draw a parse tree for the last sentence of cardiaccatheterization report shown in Figure 8.7.
5. Using the grammar in Figure 8.4, draw parse trees for the following sentences: no increase in temperature; low grade fever; marked improvement in pain; not breathing. (Hint: some lexemes have more than one word.)
6. Identify all the referential expressions in the text below and determine the correct referent for each. Assume that the computer attempts to identify referents by finding the most recent noun phrase. How well does this resolution rule work? Suggest a more effective rule.

The patient went to receive the AV fistula on December 4. However, he refuses transfusion. In the operating room it was determined upon initial incision that there was too much edema to successfully complete the operation and the incision was closed with staples. It was well tolerated by the patient.

Week 9 Question

1. What is the general principle that underlies computed axial tomography (CT)? What are the advantages of CT images over conventional X-ray images?
2. Explain the general principle underlying magnetic resonance imaging (MRI)? What are the advantages of this method compared to older methods of imaging?
3. Explain the differences among contrast, spatial, and temporal resolution.
   

   Answer:

   All photographs can indeed be influenced by different system performance variables. Spatial resolution, contrast resolution, and temporal resolution have been the most important of those dimensions. Such variables were commonly used to describe conventional X-ray images; these often give a comprehensive way to compare image captured by regimens of image processing. Spatial resolution is equivalent to a sharpening of its picture; it is a calculation about how well the image formulation could differentiate closely related features upon this picture. Spatial resolution for either an image processing is usually measured by the number of dimensions per region of interest. Current images with X-rays have spatial resolution as well as a medium cost. They could also be developed in real time (fluoroscopy) and made utilizing compact equipment.Spatial resolution is a concept expressed as the number of pixels used to create a digital image. Photos with fine spatial resolution are made of more pixels than that of the ones of low resolution. The successful temporal resolution would also rely about how the conditions characterized deals with the information highlighted; compression makes HD content quite convenient to convert to SD. But there's no such thing as "HD quality" as opposed to normal ads. Contrast resolution is indeed an indicator of the capacity to discern minor variations in magnitude, that were in effect attributable to changes in observable variables like amplification by X-rays. The number of bits per pixel in digital files is proportional to something like the contrast resolution of a picture. Hence, it seems to be the capable of distinguishing between both the intensity differences inside an image. Defining quantities is often challenging, as it focuses just much more on the human observer as being on the nature of the actual picture. For instance, the dimensions of a characteristic influences what conveniently the spectator detects that as well. Temporal resolution is an indicator of the total of duration required to develop a picture. We interpret an imaging modality to become an operation in real time, when it can photorealistic detailed at the very same moment as the physical process that it has been processing. It's indeed possible to develop unblurred photographs of the physical body at a rate of at least 30 fps. This can be improved by reducing differences in speckles. Although speckle is attributable to consistent intervention by scatterers within the same sample range, the fluctuations of speckles could only be diminished by incoherent processing (that is by discarding knowledge through stage of development). This is expressed as the proportion of time needed again for exact same situation to retrieve and retrieve the information. Once applicable to satellite imagery, the number of hours focuses upon this system platform's orbital characteristics and sensor characteristics. Thus, it includes information about the distance involved among acquiring multiple characters with the same region.

   A reasonable formulation of scanning would generate features with different spatial, contrast, and temporal resolution; it would have been relatively cheap, compact, risk-free, painless, and non-invasive; it would use non-ionizing radiation; and that would represent both physiological and anatomical processes.

4. Describe the four standard image-processing steps, and suggest how these might be applied by an imageanalysis program looking for abnormal cells in a PAP smear.
   

   Answer:

   Pictures can be augmented to allow human browsing, display views that are not representative of the original photographs, reported poor neighborhoods besides clinician closer inspection, evaluate the size and weight of a part of the body, and begin preparing pictures for assimilation with the other details. Most programs demand one or more of the chief critical steps of photo editing: global processing, personalization, feature identification and sorting. Broadly speaking, these operations are repeated in attempt, even though later steps might still feedback to previous stages so not all steps are needed with each implementation. Most measures make generalizations from two-dimensional to three-dimensional images, and therefore increased image analysis issues and risks are created by three-dimensional images.

   Global procedure includes calculations over the whole image, regardless of the underlying media production. The aim of this is to improve a picture for individual representation as well as further computer simulations. Grey level windowing of CT images is indeed a subtle but effective illustration. That being said, individuals cannot discern more than 100 shades of gray.

   Segmentation requires the selection from either the current appearance of the regions of interest ( ROIs). The ROIs quick preview to objects which are physiologically important, like organs or sections of organs. The frameworks can be defined by their edges, whereby edge-detection technologies have been used or through their edges picture construction, where in scenario region-detection techniques are employed.

   Feature detection refers to the process by which useful specifications are extracted from either the segmentation results. For instance, the volume of the heart or the size of the fetus might become insightful on such criteria respectively. They could also be used as feedback through a computerized classification task that identifies the value of attribute that has been discovered. Screening uses global processing, segmentation, identification of features, including classification to decide how a radiologist or pathologist will mark a picture through careful examination. Under such a methodology, a fair number of regular photographs (false positives) may be detected by the machine as long as a few irregular photographs (false negatives) are missing. Unless the number of highlighted images is limited proportional to the value number of photographs, then there could be economically feasible automated identification techniques. Screening approaches have been widely implemented to mammography data to extract mass lesions and microcalcification fragments, to chest X-rays for smaller cancer nodules as well as to Papanicolaou (Pap) smears for cancer or precancer cells along with identification to the various other pictures.

5. What is the segmentation step in image analysis? Why is it so difficult to perform? Give two examples of ways by which current systems avoid the problem of automatic seg-mentation. Give an example of how knowledge about the problem to be solved (e.g., local anatomy) could be used in future systems to aid in automatic segmentation.
6. What additional informatics issues arise when going from two-dimensional to three-dimensional image processing? What are the three-dimensional versions of two-dimensional image-processing operations such as region growing and edge finding?
7. What is a three-dimensional brain atlas? What are the methods for registering a patient image volume to that atlas? What is the use of a brain atlas?
8. Give some example techniques for imaging the function of the brain.



Answer:

Brain imaging techniques could widely be classified as per the sources of energy as per the procedure as following:

Ultrasound, encompassing carotid doppler and transcranial doppler

X-rays incorporating angiography

Computed Tomography (CT)

Myelography

Magnetic Fields as per the magnetoencephalography (MEG)

Electroencephalography (EEG)

Positron Emission Tomography (PET)

Magnetic Resonance Imaging (MRI).