title: Web-based health services and clinical decision support.
abstract: The purpose of this study was the development of a Web-based e-health service for comprehensive assistance and clinical decision support. The service structure consists of a Web server, a PHP-based Web interface linked to a clinical SQL database, Java applets for interactive manipulation and visualization of signals and a Matlab server linked with signal and data processing algorithms implemented by Matlab programs. The service ensures diagnostic signal- and image analysis-sbased clinical decision support. By using the discussed methodology, a pilot service for pathology specialists for automatic calculation of the proliferation index has been developed. Physicians use a simple Web interface for uploading the pictures under investigation to the server; subsequently a Java applet interface is used for outlining the region of interest and, after processing on the server, the requested proliferation index value is calculated. There is also an "expert corner", where experts can submit their index estimates and comments on particular images, which is especially important for system developers. These expert evaluations are used for optimization and verification of automatic analysis algorithms. Decision support trials have been conducted for ECG and ophthalmology ultrasonic investigations of intraocular tumor differentiation. Data mining algorithms have been applied and decision support trees constructed. These services are under implementation by a Web-based system too. The study has shown that the Web-based structure ensures more effective, flexible and accessible services compared with standalone programs and is very convenient for biomedical engineers and physicians, especially in the development phase.
authors.affiliation: Biomedical Engineering Institute, Kaunas University of Technology, Studentu 65, Kaunas, LT-51369, Lithuania. darius.jegelevicius@ktu.lt
authors.forename: Darius
authors.initials: D
authors.lastname: Jegelevicius
authors.forename: Vaidotas
authors.initials: V
authors.lastname: Marozas
authors.forename: Arunas
authors.initials: A
authors.lastname: Lukosevicius
authors.forename: Martynas
authors.initials: M
authors.lastname: Patasius
mesh_terms: D000328:Adult; D002309:Cardiology; D020000:Decision Support Systems, Clinical; D003663:Decision Trees; D005134:Eye Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D020407:Internet; D008097:Lithuania; D008297:Male; D008875:Middle Aged; D010338:Pathology, Clinical; D017216:Telemedicine; D019113:Telepathology; D014463:Ultrasonography