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Background: It is 50 years since the International Federation of Information Processing (IFIP) Societies approved the formation of a new Technical Committee (TC) 4 on Medical Information Processing under the leadership of Professor Francois Grémy, which was the direct precursor of the International Medical Informatics Association (IMIA). Objectives: The goals of this paper are to give a very brief overview of early international developments leading to informatics in medicine, with the origins of the applications of computers to medicine in the USA and Europe, and two meetings - of the International Society of Cybernetic Medicine, and the Elsinore Meetings on Hospital Information Systems-that took place in 1966. These set the stage for the formation of IFIP-TC4 the following year, with later sponsorship of the first MEDINFO in 1974, setting the path for the evolution to IMIA. Methods: This paper reviews and analyzes some of the earliest research and publications, together with two critical contrasting meetings in 1966 involving international activities in what evolved into biomedical and health informatics in terms of their probable influence on the formation of IFIP-TC4. Conclusion: The formation of IFIP-TC 4 in 1967 by Francois Grémy arose out of his concerns for merging, at an international level, the diverse strands from the more abstract work on cybernetic medicine and its basis in biophysical and neural modeling, with the more concrete and health-oriented medical information processing that was developing at the time for hospitals and clinical decision-making., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (Georg Thieme Verlag KG Stuttgart.)

May 1st, 2017, will mark Dieter Bergemann's 80th birthday. As Chief Executive Officer and Owner of Schattauer Publishers from 1983 to 2016, the biomedical and health informatics community owes him a great debt of gratitude. The past and present editors of Methods of Information in Medicine, the IMIA Yearbook of Medical Informatics, and Applied Clinical Informatics want to honour and thank Dieter Bergemann by providing a brief biography that emphasizes his contributions, by reviewing his critical role as an exceptionally supportive publisher for Schattauer's three biomedical and health informatics periodicals, and by sharing some personal anecdotes. Over the past 40 years, Dieter Bergemann has been an influential, if behind-the-scenes, driving force in biomedical and health informatics publications, helping to ensure success in the dissemination of our field's research and practice., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (Georg Thieme Verlag KG Stuttgart.)

Background: The 50th Anniversary of IMIA will be celebrated in 2017 at the World Congress of Medical Informatics in China. This takes place 50 years after the International Federation of Information Processing (IFIP) Societies approved the formation of a new Technical Committee (TC) 4 on Medical Information Processing, which was the predecessor of IMIA, under the leadership of Dr. Francois Grémy. The IMIA History Working Group (WG) was approved in 2014 to document and write about the history of the field and its organizations. Objectives: The goals of this paper are to describe how the IMIA History WG arose and developed, including its meetings and projects, leading to the forthcoming 50th Anniversary of IMIA. Methods: We give a chronology of major developments leading up to the current work of the IMIA History WG and how it has stimulated writing on the international history of biomedical and health informatics, sponsoring the systematic compilation and writing of articles and stories from pioneers and leaders in the field, and the organization of workshops and panels over the past six years, leading towards the publication of the contributed volume on the 50th IMIA Anniversary History as an eBook by IOS Press. Conclusions: This article leads up to the IMIA History eBook which will contain original autobiographical retrospectives by pioneers and leaders in the field, together with professional organizational histories of the national and regional societies and working groups of IMIA, with commentary on the main themes and topics which have evolved as scientific and clinical practices have changed under the influence of new insights, technologies, and the changing socio-economic, cultural and professional circumstances around the globe over the past 50 years., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (Georg Thieme Verlag KG Stuttgart.)

The first generation of Artificial Intelligence (AI) in Medicine methods were developed in the early 1970's drawing on insights about problem solving in AI. They developed new ways of representing structured expert knowledge about clinical and biomedical problems using causal, taxonomic, associational, rule, and frame-based models. By 1975, several prototype systems had been developed and clinically tested, and the Rutgers Research Resource on Computers in Biomedicine hosted the first in a series of workshops on AI in Medicine that helped researchers and clinicians share their ideas, demonstrate their models, and comment on the prospects for the field. These developments and the workshops themselves benefited considerably from Stanford's SUMEX-AIM pioneering experiment in biomedical computer networking. This paper focuses on discussions about issues at the intersection of medicine and artificial intelligence that took place during the presentations and panels at the First Rutgers AIM Workshop in New Brunswick, New Jersey from June 14 to 17, 1975.

This article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper "Biomedical Informatics: We Are What We Publish", written by Peter L. Elkin, Steven H. Brown, and Graham Wright. It is introduced by an editorial. This article contains the combined commentaries invited to independently comment on the Elkin et al. paper. In subsequent issues the discussion can continue through letters to the editor.

Objectives: To provide an editorial introduction to the 2012 IMIA Yearbook of Medical Informatics with an overview of its contents and contributors., Methods: A brief overview of the main theme, and an outline of the purposes, contents, format, and acknowledgment of contributions for the 2012 IMIA Yearbook., Results: This 2012 issue of the IMIA Yearbook highlights important developments in personal health informatics, impacting the activities in research, education and practice in this interdisciplinary field. There has been steady progress towards introducing individualization or personalization into informatics systems by taking advantage of the increasing amounts of personal information that is relevant to medical decisions and application in clinical practice. At the same time, there are serious issues about the limits of existing systems being able to effectively personalize information within both practical and ethical constraints so critical to the practice of medicine. Recent literature bearing on these questions includes the selected papers published during the past 12 months, and articles reported by IMIA Working Groups on these topics., Conclusion: Surveys of the main research sub-fields in biomedical informatics in the Yearbook provide an overview of progress and current challenges across the spectrum of the discipline, focusing on the challenges and opportunities involved in personal health informatics.

Background: Biomedical Informatics (BMI) is a broad discipline, having evolved from both Medical Informatics (MI) and Bioinformatics (BI). An analysis of publications in the fieldshould provide an indication about the geographic distribution of BMI research contributions and possible lessons for the future, both for research and professional practice., Objectives: In part I of our analysis of biomedical informatics publications we presented results from BMI conferences. In this second part, we analyse BMI journals, which provide a broader perspective and comparison between data from conferences and journals that ought to confirm or suggest alternatives to the original distributional findings from the conferences., Methods: We manually collected data about authors and their geographical origin from various MI journals: the International Journal of Medical Informatics (IJMI), the Journal of Biomedical Informatics (JBI), Methods of In formation in Medicine (MIM) and The Journal of the American Medical Informatics Association (JAMIA). Focusing on first authors, we also compared these findings with data from the journal Bioinformatics., Results: Our results confirm those obtained in our analysis of BMI conferences - that local and regional authors favor their corresponding MI journals just as they do their conferences. Consideration of other factors, such as the increasingly open source nature of data and software tools, is consistent with these findings., Conclusions: Our analysis suggests various indicators that could lead to further, deeper analyses, and could provide additional insights for future BMI research and professional activities.

Background: In the past decade, Medical Informatics (MI) and Bioinformatics (BI) have converged towards a new discipline, called Biomedical Informatics (BMI) bridging informatics methods across the spectrum from genomic research to personalized medicine and global healthcare. This convergence still raises challenging research questions which are being addressed by researchers internationally, which in turn raises the question of how biomedical informatics publications reflect the contributions from around the world in documenting the research., Objectives: To analyse the worldwide participation of biomedical informatics researchers from professional groups and societies in the best-known scientific conferences in the field. The analysis is focused on their geographical affiliation, but also includes other features, such as the impact and recognition of the conferences., Methods: We manually collected data about authors of papers presented at three major MI conferences: Medinfo, MIE and the AMIA symposium. In addition, we collected data from a BI conference, ISMB, as a comparison. Finally, we analyzed the impact and recognition of these conferences within their scientific contexts., Results: Data indicate a predominance of local authors at the regional conferences (AMIA and MIE), whereas other conferences with a world-wide scope (Medinfo and ISMB) had broader participation. Our analysis shows that the influence of these conferences beyond the discipline remains somewhat limited., Conclusions: Our results suggest that for BMI to be recognized as a broad discipline, both in the geographical and scientific sense, it will need to extend the scope of collaborations and their interdisciplinary impacts worldwide.

Objective: To discuss international aspects as they relate to the convergence of disciplines in health informatics., Method: A group of international experts was invited at a symposium to present and discuss their perspectives on this topic. These have been collated in a single manuscript., Results and Conclusions: Significant challenges, as well as opportunities, appear when cumulating the intrinsic multidisciplinary nature of health informatics interventions with the diversity of contexts at the global level, in particular when considered in the perspective of a confluence, i.e., the mixing of different waters and their merging into a new, stronger entity. Health informatics experts reflect on key issues such as collaborative software development and distributed knowledge sourcing, social media and mobile technologies, the evolutions of the discipline from an historical perspective, as well as examples of challenges for implementing ubiquitous healthcare or for supporting disaster situations when infrastructures get disrupted.

Background: Nanomedicine and nanoinformatics are novel disciplines facing substantial challenges. Since nanomedicine involves complex and massive data analysis and management, a new discipline named nanoinformatics is now emerging to provide the vision and the informatics methods and tools needed for such purposes. Methods from biomedi-cal informatics may prove applicable with some adaptation despite nanomedicine involving different biophysical and biochemical characteristics of nanomaterials and corresponding differences in information complexity., Objectives: We analyze recent initiatives and opportunities for research in nanomedicine and nanoinformatics as well as the previous experience of the authors, particularly in the context of a European project named ACTION-Grid. In this project the authors aimed to create a collaborative environment in biomedical and nanomedical research among countries in Europe, Western Balkans, Latin America, North Africa and the USA., Methods: We review and analyze the rationale and scientific issues behind the new fields of nanomedicine and nanoinformatics. Such a review is linked to actual research projects and achievements of the authors within their groups., Results: The work of the authors at the intersection between these two areas is presented. We also analyze several research initiatives that have recently emerged in the EU and USA context and highlight some ideas for future action at the international level., Conclusions: Nanoinformatics aims to build new bridges between medicine, nanotechnology and informatics, allowing the application of computational methods in the nano-related areas. Opportunities for world-wide collaboration are already emerging and will be influential in advancing the field.

Objectives: Biomedical ontologies have been very successful in structuring knowledge for many different applications, receiving widespread praise for their utility and potential. Yet, the role of computational ontologies in scientific research, as opposed to knowledge management applications, has not been extensively discussed. We aim to stimulate further discussion on the advantages and challenges presented by biomedical ontologies from a scientific perspective., Methods: We review various aspects of biomedical ontologies going beyond their practical successes, and focus on some key scientific questions in two ways. First, we analyze and discuss current approaches to improve biomedical ontologies that are based largely on classical, Aristotelian ontological models of reality. Second, we raise various open questions about biomedical ontologies that require further research, analyzing in more detail those related to visual reasoning and spatial ontologies., Results: We outline significant scientific issues that biomedical ontologies should consider, beyond current efforts of building practical consensus between them. For spatial ontologies, we suggest an approach for building "morphospatial" taxonomies, as an example that could stimulate research on fundamental open issues for biomedical ontologies., Conclusions: Analysis of a large number of problems with biomedical ontologies suggests that the field is very much open to alternative interpretations of current work, and in need of scientific debate and discussion that can lead to new ideas and research directions.

Objective: To give an overview of publications directly referencing the International Medical Informatics Association (IMIA) in 2008., Method: Systematic search for references to IMIA over the two official IMIA journals, and reports of the recent IMIA General Assembly and Board meetings, using PubMed/Medline, supplemented by searches with Google Scholar and Google Books., Results: Beyond the IMIA Yearbook 2008, 38 IMIA-referencing publications were found by these searches, encompassing a broad range of topics, ranging from ambient assisted living technologies in home environments to global information management methodologies., Conclusions: In 2008 IMIA-referencing publications found through both medical and general search engines were predominantly in journals. In years where IMIA's world congress on medical informatics, Medinfo take place, it could be expected that the Medinfo proceedings will also play an important role in referencing IMIA explicitly.

Objectives: To discuss translational medicine advances challenging biomedical and health informatics., Methods: Reviewing material presented at the Heidelberg 35th Anniversary Workshop, summarizing results from the 1st AMIA Summit on Translational Bioinformatics and discussing the opportunities, difficulties, and ethical dilemmas confronting researchers, practitioners, and healthcare managers in transitional bioinformatics., Results: The first results in translational medicine are appearing in the biomedical literature. All rely on bioinformatics methods for analysis., Conclusions: Translational medicine introduces new problems of interpretation and application to healthcare. Applying results to complex human-machine systems raises ethical issues, which are augmented in healthcare informatics. Bridging biological, medical, and informatics knowledge requires new epistemological approaches.

Objectives: To summarize and highlight the role of IMIA in the past 40 years in becoming the international professional organization that brings together researchers, practitioners, and educators in the field of medical informatics, and more broadly biomedical, nursing, and health informatics, Method: Outlining developments of medical informatics related to IMIA from 1967 to 2007 in a time-line and comparative topic and geographical distribution analyses over selected MEDINFOs from 1980 and selected Yearbooks from 1992 onwards. This illustrates how IMIA, through the global reach of its activities, has helped advance the science and development of informatics across the entire spectrum of biomedical and health care research, education, and practice., Results and Conclusions: The contribution of IMIA over the past 40 years has been to sponsor and coordinate international conferences and promote interchange and collaborations in biomedical and health informatics by linking national and regional societies, organizing meetings, high quality publications, and working groups. These have helped the coalescing of the discipline worldwide, promoting full participation and a broad interdisciplinary scope that fulfills the hopes of the pioneers in the field.

Objectives: To provide an editorial introduction to the 2007 IMIA Yearbook of Medical Informatics with an overview of its contents and contributors., Methods: A brief overview of the main theme of "Biomedical Informatics for Sustainable Health Systems", and an outline of the purposes, contents, format, and acknowledgment of contributions for the 2007 IMIA Yearbook., Results: In resonance with the MEDINFO 2007 conference theme "Building Sustainable Health Systems", this issue of the Yearbook examines the role of healthcare informatics in helping face the challenge of sustainability for our health systems, through a number of original contributions, and selected papers published during the past 12 months., Conclusion: This timely topic, along with the review and surveys on the main streams of research in medical informatics, offer a complete overview of the development of our field. This current state of affairs is put in the perspective of the fortieth birthday of IMIA, reflecting on the past achievements of the Association, and outlining its potential to continue shaping the world of medical informatics.

Objectives: To contribute a new perspective on recent investigations into the scientific foundations of medical informatics (MI) and bioinformatics (BI). To support efforts that could generate synergies and new research directions., Methods: MI and BI are compared and contrasted from a philosophy of science perspective. Historical examples from MI and BI are analyzed based on contrasting viewpoints about the evolution of scientific disciplines., Results: Our analysis suggests that the scientific approaches of MI and BI involve different assumptions and foundations, which, together with largely non-overlapping communities of researchers for the two disciplines, have led to different courses of development. We indicate how their respective application domains, medicine, and biology may have contributed to these differences in development., Conclusions: An analysis from the point of view of the philosophy of science is characteristic of established scientific disciplines. From a Kuhnian perspective, both disciplines may be entering a period of scientific crisis, where their foundations are questioned and where new ideas (or paradigm shifts) and a progressive research programme are needed to advance them scientifically. We discuss research directions and trends both supporting and challenging integration of the subdisciplines of MI and BI into a unified field of biomedical informatics (BMI), centered around the evolution of information cybernetics.

Objectives: To review recent research efforts in the field of ubiquitous computing in health care. To identify current research trends and further challenges for medical informatics., Methods: Analysis of the contents of the Yearbook on Medical Informatics 2005 of the International Medical Informatics Association (IMIA)., Results: The Yearbook of Medical Informatics 2005 includes 34 original papers selected from 22 peer-reviewed scientific journals related to several distinct research areas: health and clinical management, patient records, health information systems, medical signal processing and biomedical imaging, decision support, knowledge representation and management, education and consumer informatics as well as bioinformatics. A special section on ubiquitous health care systems is devoted to recent developments in the application of ubiquitous computing in health care. Besides additional synoptical reviews of each of the sections the Yearbook includes invited reviews concerning E-Health strategies, primary care informatics and wearable healthcare., Conclusions: Several publications demonstrate the potential of ubiquitous computing to enhance effectiveness of health services delivery and organization. But ubiquitous computing is also a societal challenge, caused by the surrounding but unobtrusive character of this technology. Contributions from nearly all of the established sub-disciplines of medical informatics are demanded to turn the visions of this promising new research field into reality.

Objectives: To summarize the challenges facing clinical applications in the light of growing research results in genomic medicine and bioinformatics., Methods: Analysis of the contents of the Yearbook of Medical Informatics 2004 of the International Medical Informatics Association (IMIA)., Results: The Yearbook of Medical Informatics 2004 includes 32 articles selected from 22 peer-reviewed scientific journals. A special section on clinical bioinformatics highlights recent developments in this field. Several guest editors review the promises and limitations of available methods and resources from biomedical informatics that are relevant to clinical medicine. Integrated data and knowledge resources are generally regarded to be central and key issues for clinical bioinformatics. Further review papers deal with public health implications of bioinformatics, knowledge management and trends in health care education. The Yearbook includes for the first time a section on the history of medical informatics, where the significant impact of the Reisensburg protocol 1973 on international health and medical informatics education is examined., Conclusions: Close collaboration between bioinformatics and medical informatics researchers can contribute to new insights in genomic medicine and contribute towards the more efficient and effective use of genomic data to advance clinical care.

Objectives: The Yearbook of Medical Informatics is published annually by the International Medical Informatics Association (IMIA) and contains a selection of excellent papers on medical informatics research which have been recently published (http://www. yearbook.uni-hd.de). The 2003 Yearbook of Medical Informatics took as its theme the role of medical informatics for the quality of health care. In this paper, we will discuss challenges for health care, and the lessons learned from editing IMIA Yearbook 2003., Results and Conclusions: Modern information processing methodology and information and communication technology have strongly influenced our societies and health care. As a consequence of this, medical informatics as a discipline has taken a leading role in the further development of health care. This involves developing information systems that enhance opportunities for global access to health services and medical knowledge. Informatics methodology and technology will facilitate high quality of care in aging societies, and will decrease the possibilities of health care errors. It will also enable the dissemination of the latest medical and health information on the web to consumers and health care providers alike. The selected papers of the IMIA Yearbook 2003 present clear examples and future challenges, and they highlight how various sub-disciplines of medical informatics can contribute to this.

Objective: To describe potential areas of collaboration between Medical Informatics (BI) and Bioinformatics (BI) and their effects on planning future work in both disciplines., Methods: Some reflections on the objectives and rationale underpinning MI and BI are given, and preliminary results from the BIOINFOMED workgroup, supported by the European Commission, are introduced., Results: Applications from both subfields suggest topics for sharing and exchange between the subfields within the emerging field of Biomedical Informatics., Conclusions: We suggest how the nature and degree of collaboration between the sub-disciplines can impact future work in molecular medicine.

Objectives: The Yearbook of Medical Informatics is published annually by the International Medical Informatics Association (IMIA) and contains a selection of recent excellent papers on medical informatics research (http://www.yearbook.uni-hd.de). The 2002 Yearbook of Medical Informatics took as its theme the topic of Medical Imaging Informatics. In this paper, we will summarize the contributions of medical informatics researchers to the development of medical imaging informatics, discuss challenges and opportunities of imaging informatics, and present the lessons learned from the IMIA Yearbook 2002., Results and Conclusions: Medical informatics researchers have contributed to the development of medical imaging methods and systems since the inception of this field approximately 40 years ago. The Yearbook presents selected papers and reviews on this important topic. In addition, as usual, the Yearbook 2002 also contains a variety of papers and reviews on other subjects relevant to medical informatics, such as Bioinformatics, Computer-supported education, Health and clinical management, Health information systems, Knowledge processing and decision support, Patient records, and Signal processing.

Background: Medical informatics has always encompassed a very broad spectrum of techniques for clinical and biomedical research, education and practice. There has been a concomitant variety of depth of specialization, ranging from the routine application of information processing methods to cutting-edge research on fundamental problems of computer-based systems and their relations to cognition and perception in biomedicine., Objectives: Challenges for the field can be placed in perspective by considering the scale of each--from the highly detailed scientific problems in bioinformatics and emerging molecular medicine to the broad and complex social problems of introducing medical informatics into web-related global settings., Methods: The scale of an informatics problem is not only determined by the inherent physical space in which it exists, but also by the conceptual complexity that it involves, reinforcing the need to investigate the semantic web within which medical informatics is defined., Results and Conclusion: Bioinformatics, biomedical imaging and language understanding provide examples that anchor research and practice in biomedical informatics at the detailed, scientific end of the spectrum. Traditional concerns of medical informatics in the clinical arena make up the broad mid-range of the spectrum, while novel social interaction models of competition and cooperation will be needed to understand the implications of distributed health information technology for individual and societal change in an increasingly interconnected world.

The Yearbook of Medical Informatics is published annually by the International Medical Informatics Association (IMIA) and contains a selection of recent excellent papers on medical informatics research (http://www.med.uni-heidelberg.de/mi/yearbook/index.htm). The special topic of the just published Yearbook 2001 is "Digital Libraries and Medicine". Digital libraries have changed dramatically and will continue to change the way we work with medical knowledge. The selected papers present recent research and new results on digital libraries. As usual, the Yearbook 2001 also contains a variety of papers on other subjects relevant to medical informatics, such as Electronic Patient Records, Health Information Systems, Health and Clinical Management, Decision Support Systems, Education, as well as Image and Signal Processing. This paper will briefly introduce the contributions covering digital libraries and will show how medical informatics research contributes to this important topic.

Technology breakthroughs in high-speed, high-capacity, and high performance desk-top computers and workstations make the possibility of integrating multimedia medical data to better support clinical decision making, computer-aided education, and research not only attractive, but feasible. To systematically evaluate results from increasingly automated image segmentation it is necessary to correlate them with the expert judgments of radiologists and other clinical specialists interpreting the images. These are contained in increasingly computerized radiological reports and other related clinical records. But to make automated comparison feasible it is necessary to first ensure compatibility of the knowledge content of images with the descriptions contained in these records. Enough common vocabulary, language, and knowledge representation components must be represented on the computer, followed by automated extraction of image-content descriptions from the text, which can then be matched to the results of automated image segmentation. A knowledge-based approach to image segmentation is essential to obtain the structured image descriptions needed for matching against the expert's descriptions. We have developed a new approach to medical image analysis which helps generate such descriptions: a knowledge-based object-centered hierarchical planning method for automatically composing the image analysis processes. The problem-solving steps of specialists are represented at the knowledge level in terms of goals, tasks, and domain objects and concepts separately from the implementation level for specific representations of different image types, and generic analysis methods. This system can serve as a major functional component in incrementally building and updating a structured and integrated hybrid information system of patient data.(ABSTRACT TRUNCATED AT 250 WORDS)

Advanced radiology practices are already benefiting from powerful and increasingly more economical computing and networking facilities. Medical image processing methods have improved dramatically over the past five years, with sophisticated 3D display, visualization and analysis techniques allowing increased integration of multiple modalities of imaging, flexible environments for imaging analysis, and PACS (picture archiving and communication systems) for ease of transmission and retrieval. Emerging directions involve teleradiology and telesurgery virtual reality applications, the development of new image database techniques, and the building of large visual databases like that of the Visible Human Project. Challenging problems of image segmentation, registration, and multimodal image fusion are still with us. Building dynamic, flexible electronic atlases will have a profound effect on the understanding of structure and function from the level of cellular physiology to gross anatomy, but requires the development of new techniques of visual knowledge representation and more standardized ways of defining the conceptual and linguistic constructs of visual objects in biomedicine, for linkage to medical records, research results, and educational materials. Methods for reasoning with visual information in the context of multimedia information systems present an inviting challenge to the upcoming generation of researchers in medical informatics.