PROJECTS - MEDICAL INFORMATICS

• AURAWeb - Meta Search Engine for Diagnostic Findings
• Automatic Identification of Diagnostically Significant Regions in CLSM-Images of Melanomas
• Data Protection in Research and Education
• EMERGE - Emergency Monitoring and Prevention
• Interface Contact Matrix - Analysis and Visualization of Protein Interactions
• *Med-Report Portal
• PACSview and Cardiac@view
• Randomizer - Randomization for Clinical Trials
• [Historical:] Image Distribution and Clinical Applications

AURAWeb - Meta Search Engine for Diagnostic Findings

During the introduction of a new HIS and the installation of a new departmental Information System for the Institute of Pathology, several older systems (AURA - developed in the 1970s and 1980s) were gradually replaced. However, access to the medical data stored in these systems had to be ensured. In order to avoid a complicated and expensive transfer of several million records into the new system, we developed AURAWeb, a web-based Meta Search Engine for diagnostic findings.

AURAWeb has been in routine use since 2002 and enables access to approximately 12 million records from 33 different medical information systems and - in the context of radiological findings - digital images from 14 PACS. The scope of application is no longer limited to legacy systems. In different fields - for example, pathology - the volume of data of all documentation systems relevant to the specific search are scanned, thereby providing a comprehensive and complete view of the available findings of a patient.

The search for medical findings is carried out directly in the databases (or associated search engines) of the participating medical information systems, which are accessed via different interfaces - SOAP, REST, DICOM, JDBC™, etc. AURAWeb is responsible for the authentication and authorization of the user, the selection of the information systems to be contacted, the transformation and co-ordination of the retrieval queries, as well as the collection, preparation and presentation of the result. The specific characteristics of the individual information systems are not of relevance to the user. Apart from the browser based user interface, AURAWeb also makes a direct access to the search engine available, via a Web service interface, and is, therefore, a Service Provider for the search for medical findings in a Service Oriented Architecture (SOA).

Automatic Identification of Diagnostically Significant Regions in CLSM-Images of Melanomas

The Confocal Laser Scanning Microscopy (CLSM) makes a fast, in-vivo screening of alterations in dermal tissue possible (3-5 minutes per lesion). Since this is a new procedure and the pictorial material won from it distinctly differs from pictures created by the conventional Transmission Light Microscopy, the diagnostic parameters have not been completely ascertained. In this study, conducted in collaboration with the Department of Internal Medicine, Division of Oncology and the Department of Dermatology and Venereology, diagnostically highly significant regions in CLSM-images of Melanoma are determined by means of automatic image analysis and emphasized within the image.

Since, with connective tissue, an automatic segmentation of individual cells is not generally possible, the images are divided into individual quadrants and the characteristics, attained from a Wavelet Transformation in different resolutions, are computed within the quadrants. As a further consequence, classification rules, generated by means of a CART analysis, are applied as a set of diagnostic rules and quadrants, classified by these rules, are accordingly marked within the image.

By these means, diagnostically highly significant regions in Melanoma images can automatically be emphasized. The results agree very well with the results of the purely visual evaluation. In this way, an evaluation "benign versus malignant", can be made accessible for an objective valuation - as opposing a subjective estimate of the diagnostician.

Data Protection in Research and Education

With the introduction of the Austrian Data Protection Act 2000, a set of changes and reforms concerning the use of data came into force. Thus

• the legal requirements pertaining to data access have been newly regulated,
• the scope of application was also expanded to include data in manual structured format (lists, card indices, etc.)
• the criteria for registration to access personal data in the Data Processing Register have been tightened and
• the guidelines regarding data transfer with foreign countries have been modified.

In order to provide support during the practical realization of this legal norm in research and education, in particular within the field of the human sciences, we compiled a Data Protection Policy [PDF, German only, 302 kB] on behalf of the Federal Ministry for Education, Science and Culture and the civic authorities of Vienna (Gemeinde Wien). A significant result, thereof, was the creation of a set of rules, which met the Data Protection Basic Regulations without causing a high increase in the time and effort required for bureaucracy within the scientific activities.

EMERGE - Emergency Monitoring and Prevention

Improving the quality of life of elderly people and, above all, enabling them to stay in a familiar environment for a longer period of time is an emerging issue for both research and development within our information society. Demographical developments in Europe lead us to expect that the percentage of older people within the population will continue to increase in the future. New technology, above all Ambient Intelligence Technology, inspires hope for a versatile and comprehensive support in everyday life. Above all, it could provide support and protection for older people in emergency situations or even help to avoid them.

However, handling information technology is not always simple; particularly older people have reservations and difficulties. Strain, distrust, fear and possible refusal to accept this type of technological assistance must therefore be anticipated. This is not always due to physical or cognitive limitations but also the complexity of such systems. These problems become particularly apparent during health monitoring.

These challenges are being faced by the research project EMERGE, which is receiving financial aid from the Ambient Assisted Living Program of the European Union (Grant Number IST-2005-2.6.2 045056). The research unit HCI4MED of the IMI is responsible within EMERGE for the topics Human-Computer Interaction, Usability Engineering and Life Long Learning.

Interface Contact Matrix - Analysis and Visualization of Protein Interactions

Knowledge of the macromolecular interfaces of protein structures plays a substantial role in understanding mutual reaction and biological functions. Examples of this are immune complexes (anti-bodies - antigen) and receptor factor compounds in clinical medicine.

Our software tool, which we developed in co-operation with the Jean Dausset Laboratory - Clinical Immunology (Professor G. P. Tilz), uses protein complexes from the PDB database, in order to determine the Interface Contact Matrix between 2 proteins. This is defined as a plot of paired interactions between individual amino acids of the two polypeptide chains. The amino acid chains are laid on two axles (horizontal and vertical) and an entry in the ICM is made in those places, where at least two of the atoms of both amino acids are within a certain distance. The entries are also annotated with physicochemical characteristics (such as hydrogen bonds, hydrophobic / hydrophilic characteristics etc.). The ICM thus generated is connected to the 3D-Visualisation of the macromolecular interface, so that, by means of mouse clicks in the appropriate place in the matrix, the appropriate 3D-Struktur is accentuated.

This technology enables the identification of Hot Spots on the contact surface between interacting proteins and common contact patterns at different complexes. The 3D-Visualisation also permits realistic views of the macromolecular interface structures and, by computation of the molecular surfaces of the amino acids, involved complementary surfaces can be made visible.

*Med-Report Portal

Within the framework of research projects, a service of the IMI that is frequently in demand is the retrieval of medical findings and the creation of reports from both the central hospital information system openMEDOCS and from the databases of different departmental systems.

We developed the *Med-Report Portal in order to provide scientists with reports and evaluations. The export assistant was designed by us to select and export master data and medical documents from openMEDOCS for further evaluation and analysis. Together, these two applications form a suitable solution to take advantage of the increased value for scientific work resulting from the documentation work. Thereby, special attention is paid to the quality and analyzability of the data, as well as retaining data protection.

PACSview and Cardiac@view

PACSview and Cardiac@View are applications developed by us for the display of medical pictures.

PACSview is the current standard application in the Styrian Hospitals for the display of radiological pictures conforming to DICOM. It is integrated into the PACS infrastructure and thus available in 23 Styrian Hospitals.

Cardiac@View was developed during a Usability Study, in co-operation with the Department for Internal Medicine, Division of Cardiology and the Department for Cardiology and Intensive Care of the LKH Graz/West, and is characterized by large variety of presentable image formats; the possibility of producing and presenting video sequences and its availability on various prevalent system platforms. Cardiac@View can also be extended, very simply, to include image processing functionalities by integrating modules developed in IDL.

Randomizer - Randomization for Clinical Trials

The Randomizer is a Web application, developed by the IMI, for randomization in clinical trials. The Application is designed for multi-center trials and provides - apart from different trial management functions - six different randomization methods and a simulator for testing study designs. The GCP-Compliance was affirmed by the Austrian Agency for Health and Food Safety (AGES). The software has been available since 2003 as a service of the IMI and is constantly being developed further. It has been successfully used in more than 70 clinical studies in Austria, Germany, Switzerland and the USA. Further information about the Randomizer, including a demo version, is available under http://www.randomizer.at/.

[Historical:] Image Distribution and Clinical Applications

Within our commitment in the area of Image Processing and Distribution in Medicine, our contribution to the Austrian Roentgen Congress of 1999 (Radiological-therapeutic planning laboratory, 23. - 25 September 1999, Vienna, AKH), was the presentation of Picture Distribution and Clinical Applications in the LKH University Clinic Graz (as per: December 2000, available in German only).