This article briefly describes the development of the I-COP tool, which is designed to promote education and decision making of clinical oncologists. It is based on real data from medical facilities, which are processed, stored in database, analyzed and finally displayed in an interactive software application. Used data sources are shortly described in individual sections together with the functionality of developed tools. The final goal of this project is to provide support for work and education within each involved partner center. Clinical oncologists are therefore supposed to be the authors and users at the same time.

• MeSH
• algoritmy MeSH
• data mining metody   MeSH
• elektronické zdravotní záznamy * MeSH
• lidé MeSH
• metody pro podporu rozhodování MeSH
• nádory diagnóza   terapie   MeSH
• navrhování softwaru MeSH
• registrace * MeSH
• software * MeSH
• systémy pro podporu klinického rozhodování * MeSH
• zdravotní záznamy osobní * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

While guideline-based decision support is safety-critical and typically requires human interaction, offline analysis of guideline compliance can be performed to large extent automatically. We examine the possibility of automatic detection of potential non-compliance followed up with (statistical) association mining. Only frequent associations of non-compliance patterns with various patient data are submitted to medical expert for interpretation. The initial experiment was carried out in the domain of hypertension management.

• MeSH
• dodržování směrnic * MeSH
• lékařská praxe - způsoby provádění MeSH
• lidé MeSH
• medicína založená na důkazech MeSH
• rozhodování pomocí počítače MeSH
• směrnice pro lékařskou praxi jako téma * MeSH
• software MeSH
• systémy pro podporu klinického rozhodování * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Development of the electronic health record architecture at the EuroMISE Center was inspired by existing European standards and several European projects. The developed EHR named MUDR implements a 3-layer architecture, using XML for communication between application layer and clients. A decision support module implementing the "1999 WHO/ISH Guidelines for the Management of Hypertension" is part of an application layer. Universal graph structure is used both to represent the set of medical concepts in the EHR and to represent the collected data. Advanced methods of interaction between EHR and its user are studied, software prototypes of client applications are developed and their effectiveness evaluated.

• MeSH
• chorobopisy - počítačové systémy organizace a řízení   MeSH
• metody pro podporu rozhodování MeSH
• uživatelské rozhraní počítače * MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

OBJECTIVES: Our main objective is to design a method of, and supporting software for, interactive correction and semantic annotation of narrative clinical reports, which would allow for their easier and less erroneous processing outside their original context: first, by physicians unfamiliar with the original language (and possibly also the source specialty), and second, by tools requiring structured information, such as decision-support systems. Our additional goal is to gain insights into the process of narrative report creation, including the errors and ambiguities arising therein, and also into the process of report annotation by clinical terms. Finally, we also aim to provide a dataset of ground-truth transformations (specific for Czech as the source language), set up by expert physicians, which can be reused in the future for subsequent analytical studies and for training automated transformation procedures. METHODS: A three-phase preprocessing method has been developed to support secondary use of narrative clinical reports in electronic health record. Narrative clinical reports are narrative texts of healthcare documentation often stored in electronic health records. In the first phase a narrative clinical report is tokenized. In the second phase the tokenized clinical report is normalized. The normalized clinical report is easily readable for health professionals with the knowledge of the language used in the narrative clinical report. In the third phase the normalized clinical report is enriched with extracted structured information. The final result of the third phase is a semi-structured normalized clinical report where the extracted clinical terms are matched to codebook terms. Software tools for interactive correction, expansion and semantic annotation of narrative clinical reports has been developed and the three-phase preprocessing method validated in the cardiology area. RESULTS: The three-phase preprocessing method was validated on 49 anonymous Czech narrative clinical reports in the field of cardiology. Descriptive statistics from the database of accomplished transformations has been calculated. Two cardiologists participated in the annotation phase. The first cardiologist annotated 1500 clinical terms found in 49 narrative clinical reports to codebook terms using the classification systems ICD 10, SNOMED CT, LOINC and LEKY. The second cardiologist validated annotations of the first cardiologist. The correct clinical terms and the codebook terms have been stored in a database. CONCLUSIONS: We extracted structured information from Czech narrative clinical reports by the proposed three-phase preprocessing method and linked it to electronic health records. The software tool, although generic, is tailored for Czech as the specific language of electronic health record pool under study. This will provide a potential etalon for porting this approach to dozens of other less-spoken languages. Structured information can support medical decision making, quality assurance tasks and further medical research.

• Klíčová slova
• Narrative clinical report, classification systems, electronic health record, nomenclatures, structured information, tokens,
• MeSH
• elektronické zdravotní záznamy normy   MeSH
• mezinárodní klasifikace nemocí MeSH
• psaní normy   MeSH
• řízený slovník * MeSH
• sémantika * MeSH
• směrnice jako téma MeSH
• smysluplné využití normy   MeSH
• software MeSH
• správnost dat MeSH
• strojové učení * MeSH
• uživatelské rozhraní počítače MeSH
• zpracování přirozeného jazyka * MeSH
• zpracování textu normy   MeSH
• Publikační typ
• časopisecké články MeSH

Quadrupole inductively coupled plasma mass spectrometry (Q-ICP-MS) and direct mercury analysis were used to determine the elemental composition of 180 transformed (salt-ripened) anchovies from three different fishing areas before and after packaging. To this purpose, four decision trees-based algorithms, corresponding to C5.0, classification and regression trees (CART), chi-squareautomatic interaction detection (CHAID), and quick unbiased efficient statistical tree (QUEST) were applied to the elemental datasets to find the most accurate data mining procedure to achieve the ultimate goal of fish origin prediction. Classification rules generated by the trained CHAID model optimally identified unlabelled testing bulk anchovies (93.9% F-score) by using just 6 out of 52 elements (As, K, P, Cd, Li, and Sr). The finished packaged product was better modelled by the QUEST algorithm which recognised the origin of anchovies with F-score of 97.7%, considering the information carried out by 5 elements (B, As, K. Cd, and Pd). Results obtained suggested that the traceability system in the fishery sector may be supported by simplified machine learning techniques applied to a limited but effective number of inorganic predictors of origin.

• Klíčová slova
• Data mining, Decision trees, Engraulis encrasicolus, Fish products, Geographical origin, ICP-MS,
• MeSH
• algoritmy MeSH
• rozhodovací stromy MeSH
• rtuť analýza   MeSH
• rybí výrobky analýza   MeSH
• ryby MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• rtuť MeSH

OBJECTIVES: Informed decisions about cancer screening require accurate knowledge regarding cancer risks and screening. This study investigates: (1) European women's knowledge of their risk of developing breast, ovarian, cervical or endometrial cancer, (2) their knowledge about mammography screening and (3) whether an evidence-based leaflet improves their knowledge. DESIGN: Cross-sectional online intervention survey. SETTING: National samples from five European countries (Czech Republic, Germany, UK, Italy and Sweden)-drawn from the Harris Interactive and the Toluna panel, respectively, in January 2017-were queried on their knowledge of age-specific risks of developing breast, cervical, ovarian or endometrial cancer within the next 10 years and of mammography screening before and after intervention. PARTICIPANTS: Of 3629 women (inclusion criteria: age 40-75 years) invited, 2092 responded and 1675 completed the survey (response rate: 61.4%). INTERVENTION: Evidence-based leaflet summarising information on age-adjusted female cancer risks, mammography and aspects of cancer prevention. PRIMARY OUTCOME MEASURES: Proportion of women (1) accurately estimating their risk of four female cancers, (2) holding correct assumptions of mammography screening and (3) changing their estimations and assumptions after exposure to leaflet. FINDINGS: Across countries, 59.2% (95% CI 56.8% to 61.6%) to 91.8% (95% CI 90.3% to 93.0%) overestimated their female cancer risks 7-33 fold (mediansacross tumours: 50.0 to 200.0). 26.5% (95% CI 24.4% to 28.7%) were aware that mammography screening has both benefits and harms. Women who accurately estimated their breast cancer risk were less likely to believe that mammography prevents cancer (p<0.001). After leaflet intervention, knowledge of cancer risks improved by 27.0 (95% CI 24.9 to 29.2) to 37.1 (95% CI 34.8 to 39.4) percentage points and of mammography by 23.0 (95% CI 21.0 to 25.1) percentage points. CONCLUSION: A considerable number of women in five European countries may not possess the prerequisites for an informed choice on cancer screening. Evidence-based information in patient leaflets can improve this situation.

• Klíčová slova
• breast cancer, gynecological cancers, patient education, risk literacy,
• MeSH
• časná detekce nádoru metody   MeSH
• dospělí MeSH
• internacionalita MeSH
• lidé středního věku MeSH
• lidé MeSH
• metody pro podporu rozhodování * MeSH
• nádory prsu prevence a kontrola   MeSH
• nádory ženských pohlavních orgánů patologie   prevence a kontrola   MeSH
• odhad potřeb MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• rozhodování MeSH
• senioři MeSH
• věkové faktory MeSH
• zdraví - znalosti, postoje, praxe * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Itálie MeSH
• Německo MeSH
• Švédsko MeSH

BACKGROUND: Currently, use of mechanical circulatory support (MCS) in non-ischaemic cardiogenic shock (CS) is predominantly guided by shock-specific markers, and not by markers of cardiac function. We hypothesise that left ventricular ejection fraction (LVEF) can identify patients with a higher likelihood to benefit from MCS and thus help to optimise their expected benefit. METHODS: Patients with non-ischaemic CS and available data on LVEF from 16 tertiary-care centres in five countries were analysed. Cox regression models were fitted to evaluate the association between LVEF and mortality, as well as the interaction between LVEF, MCS use and mortality. RESULTS: N = 807 patients were analysed: mean age 63 [interquartile range (IQR) 51.5-72.0] years, 601 (74.5%) male, lactate 4.9 (IQR 2.6-8.5) mmol/l, LVEF 20 (IQR 15-30) %. Lower LVEF was more frequent amongst patients with more severe CS, and MCS was more likely used in patients with lower LVEF. There was no association between LVEF and 30-day mortality risk in the overall study cohort. However, there was a significant interaction between MCS use and LVEF, indicating a lower 30-day mortality risk with MCS use in patients with LVEF ≤ 20% (hazard ratio 0.72, 95% confidence interval 0.51-1.02 for LVEF ≤ 20% vs. hazard ratio 1.31, 95% confidence interval 0.85-2.01 for LVEF > 20%, interaction-p = 0.017). CONCLUSION: This retrospective study may indicate a lower mortality risk with MCS use only in patients with severely reduced LVEF. This may propose the inclusion of LVEF as an adjunctive parameter for MCS decision-making in non-ischaemic CS, aiming to optimise the benefit-risk ratio.

• Klíčová slova
• Cardiogenic shock, Left ventricular ejection fraction, Mechanical circulatory support, Non-ischaemic,
• MeSH
• funkce levé komory srdeční MeSH
• kardiogenní šok * diagnóza   terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• podpůrné srdeční systémy * MeSH
• retrospektivní studie MeSH
• senioři MeSH
• tepový objem MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Understanding the distribution of wild medicinal plants and areas that are suitable for cultivation of these plants is important for both conservation and agriculture. Here, we study ten taxa with known ethnopharmacological uses, which have been used extensively in traditional medicine and as culinary supplements. We aim to (1) predict and map the potential habitat suitability for these taxa across the study area, (2) investigate spatial patterns that could have management implications, such as niche similarities among the taxa and suitability "hotspots" with the use of novel indices, and (3) develop a platform where parts of this information can be accessed and utilized by all interested groups, from the policy-maker level to the individual practitioner level. Ecological Niche Models developed for each study taxon, based on topographic, bioclimatic, soil, and land use variables had high predictive power and were used as the basis for suitability visualization. A series of informative indices were also calculated and mapped, revealing spatial patterns not readily observable from the single-taxon predictions, and providing valuable information to managers. Finally, a web-based, easy-to-use application was also created, where the predicted suitability scores for the study area can be made accessible to anyone interested. The application can provide information both in a visual form (i.e. maps of predicted suitability) and in a numerical form (i.e. estimated suitability scores for all taxa in a given geographical location). This study provides the scientific tools to make a step towards cultivating a group of economically important wild medicinal plants in Crete, as well as the tools to disseminate this information to decision makers and practitioners, and eventually integrate the research findings in local agricultural practices.

• Klíčová slova
• Conservation, Ecological Niche Modelling, Interactive decision support, Medicinal plants, Resupply ethnopharmacological plants,
• MeSH
• ekosystém * MeSH
• léčivé rostliny * MeSH
• monitorování životního prostředí metody   MeSH
• tradiční lékařství MeSH
• zemědělství * MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Řecko MeSH

BACKGROUND: Four strategies for very early rule-out of acute myocardial infarction using high-sensitivity cardiac troponin I (hs-cTnI) have been identified. It remains unclear which strategy is most attractive for clinical application. METHODS: We prospectively enrolled unselected patients presenting to the emergency department with symptoms suggestive of acute myocardial infarction. The final diagnosis was adjudicated by 2 independent cardiologists. Hs-cTnI levels were measured at presentation and after 1 hour in a blinded fashion. We directly compared all 4 hs-cTnI-based rule-out strategies: limit of detection (LOD, hs-cTnI<2 ng/L), single cutoff (hs-cTnI<5 ng/L), 1-hour algorithm (hs-cTnI<5 ng/L and 1-hour change<2 ng/L), and the 0/1-hour algorithm recommended in the European Society of Cardiology guideline combining LOD and 1-hour algorithm. RESULTS: Among 2828 enrolled patients, acute myocardial infarction was the final diagnosis in 451 (16%) patients. The LOD approach ruled out 453 patients (16%) with a sensitivity of 100% (95% confidence interval [CI], 99.2%-100%), the single cutoff 1516 patients (54%) with a sensitivity of 97.1% (95% CI, 95.1%-98.3%), the 1-hour algorithm 1459 patients (52%) with a sensitivity of 98.4% (95% CI, 96.8%-99.2%), and the 0/1-hour algorithm 1463 patients (52%) with a sensitivity of 98.4% (95% CI, 96.8%-99.2%). Predefined subgroup analysis in early presenters (≤2 hours) revealed significantly lower sensitivity (94.2%, interaction P=0.03) of the single cutoff, but not the other strategies. Two-year survival was 100% with LOD and 98.1% with the other strategies (P<0.01 for LOD versus each of the other strategies). CONCLUSIONS: All 4 rule-out strategies balance effectiveness and safety equally well. The single cutoff should not be applied in early presenters, whereas the 3 other strategies seem to perform well in this challenging subgroup. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00470587.

• Klíčová slova
• diagnosis, myocardial infarction, rule-out strategies,
• MeSH
• akutní koronární syndrom krev   diagnóza   mortalita   MeSH
• algoritmy MeSH
• biologické markery krev   MeSH
• časové faktory MeSH
• dospělí MeSH
• elektrokardiografie MeSH
• hodnocení rizik MeSH
• infarkt myokardu krev   diagnóza   mortalita   MeSH
• Kaplanův-Meierův odhad MeSH
• lidé středního věku MeSH
• lidé MeSH
• metody pro podporu rozhodování * MeSH
• prediktivní hodnota testů MeSH
• prognóza MeSH
• prospektivní studie MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• sexuální faktory MeSH
• troponin I krev   MeSH
• upregulace MeSH
• věkové faktory MeSH
• zdravotní stav MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• srovnávací studie MeSH
• Geografické názvy
• Evropa MeSH
• Názvy látek
• biologické markery MeSH
• troponin I MeSH

BACKGROUND: Serious games, which are gaming applications used for purposes beyond entertainment to educate users on, and address, specific issues, may present a timely approach to promote healthy diabetes management behaviors among children with type 1 diabetes mellitus (T1DM). The lasting benefits associated with these serious games encompass improved patient education; enhanced glycemic control; the reinforcement of bonds within the community of people with diabetes; the facilitation of meaningful dialogues with caregivers, especially within the familial setting; and a significant reduction in the economic burdens associated with subsequent complications. OBJECTIVE: This paper primarily aims to provide a detailed overview of the iterative design process and the associated evaluation methods used in the development of the educational game. Furthermore, this study aims to enhance motivation for sustained and extended engagement with the game over time. The MyDiabetic game design aims to educate children on various aspects, including the connections among food, insulin, and physical activity. Furthermore, it seeks to impart knowledge related to the operation of a glucometer and an insulin pen, as well as more advanced technologies such as administering glucagon, measuring ketoacidosis, and continuous glucose monitoring. METHODS: The co-design methodology was applied, involving interviews, design workshops, and prototype feedback sessions. A combination of several approaches, such as tailoring, observational learning, social and family support, decision-making practice, and reward systems, was used to support children's compliance. Moreover, incorporating the literature, guidelines, and current practices into the design ensured that the game was aligned with established health care pathways and included relevant information and best practices for diabetes management. RESULTS: The game was tested on 32 children in 3 iterations. Positive responses were received from children who tested the game as well as their parents. The game was also presented to 5 schoolmates of children with T1DM who appreciated a better understanding of the disease and the opportunity to support their friends more efficiently in T1DM compensation. The involvement of children and clinicians in participatory co-design contributed to to the game's high acceptance. With regard to the game's impact on education, 1 week of testing revealed an enhancement in educational outcomes. CONCLUSIONS: The game is especially suitable for children newly diagnosed with T1DM because it acquaints them in a fun way with new terminology; for example, they can try to measure glycemia levels in an interactive way. The game also caters to children who still need to develop reading skills by including an audio guide. The guide ensures that children of all literacy levels can benefit from the game's educational content and interactive experiences. The game is available for download on Google Play and the Apple App Store.

• Klíčová slova
• child, child with diabetes, children, co-design, diabetes, diabetes mellitus, gaming, glucometer, glucose, insulin, mobile app, mobile phone, patient education, serious game, serious games, user-centered design,
• Publikační typ
• časopisecké články MeSH