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Objective: The objective of the analysis is the technological resources that are being used to monitor the lives of the elderly. Method: A literature review was conducted in the Pubmed database considering 2013 january to 2017 december period. Results: Technological resources were treated as with the support of the daily tools of the elderly and the technological resources used in the Ambient Assisted Living (AAL). The pages were selected with the purpose of knowing the resources that are being used, as well as the advantages and the restrictions of its implementation. It was identified as Generations of AAL. Conclusion: It was verified that the researches on the implantation of the technologies in the accompaniment of the elderly are being carried out in an experimental character. Through the analysis of the material it was observed that several technological resources can be employed, configuring in Assisted Living Environment generations. Based on this analysis, the proposal of the Fourth Generation was elaborated in such a way that interoperability occurs between the technological devices, and that the use of technologies can collaborate with the quality of life and social interaction of the elderly. Objetivo: O objetivo desta revisão é identificar os recursos tecnológicos que estão sendo utilizados no acompanhamento de vida dos idosos. Método: Foi realizada pesquisa de literatura de artigos publicados entre janeiro de 2013 a dezembro de 2017 na base Pubmed. Resultados: Foram selecionados artigos que descrevem recursos tecnológicos como apoio nas atividades diárias dos idosos e os recursos tecnológicos utilizados em Ambientes de Vida Assistida (Ambient Assisted Living AAL). Os artigos foram selecionados com o objetivo de conhecer os recursos que estão sendo empregados, as vantagens e as limitações decorrentes de sua implementação. Identificou-se as gerações de AAL. Conclusão: Constatou-se que as pesquisas sobre a implantação das tecnologias no acompanhamento de idosos ainda estão sendo realizadas em caráter experimental. Pela análise do material identificou-se que vários recursos tecnológicos podem ser empregados, configurando diferentes gerações de AAL. A partir dessa análise foi elaborada uma proposta de definição da Quarta Geração de ALL preconize interoperabilidade entre os dispositivos tecnológicos e na utilização de tecnologias que colaborem com a qualidade de vida e interação social do idoso.

To present a cognitive map to support the radiological diagnosis of solitary bone tumors, as well as to facilitate the determination of the nature of the tumor (benign or malignant), in pediatric patients.We selected 28 primary lesions in pediatric patients, and we identified the findings typically associated with each of the diagnoses. The method used for the construction of the final cognitive map was the Bayesian belief network model with backward chaining.We developed a logical, sequential structure, in the form of a cognitive map, based on the Bayesian belief network model, with the intention of simulating the sequence of human thinking, in order to minimize the number of unnecessary interventions and iatrogenic complications arising from the incorrect evaluation of bone lesions.With this map, it will be possible to develop an application that will provide support to physicians and residents, as well as contributing to training in this area and consequently to a reduction in diagnostic errors in patients with bone lesions.Apresentar um mapa cognitivo para suporte na determinação da natureza benigna ou maligna, bem como no diagnóstico radiológico, de tumores ósseos solitários na faixa etária pediátrica.Foi realizada uma seleção de 28 lesões principais na faixa etária pediátrica e dos achados característicos e associados a cada um desses diagnósticos. O método utilizado para a construção da estrutura cognitiva final foi o modelo de rede de crenças bayesianas com a técnica de encadeamento regressivo.Foi desenvolvida uma estrutura lógica e sequencial no formato de um mapa cognitivo, segundo o modelo de rede de crenças bayesianas, na tentativa de simular o raciocínio humano sequencial e minimizar esforços e iatrogenias oriundas da avaliação equivocada de lesões ósseas.Com base nesse mapa, será possível oferecer um aplicativo para apoio a profissionais e residentes médicos e colaborar com o treinamento nessa área e, consequentemente, diminuir erros no diagnóstico de uma lesão óssea.

This study aimed at describing the recent experience acquired with the implementation and use of clinical decision support system in gastroenterology in order to determine the level of development, tests used and advantages that such a system can offer to the medical practice.A search in the PubMed, LILACS and ISI Web of Knowledge databases for studies in decision-making support systems in gastroenterology including original papers produced from 2005 to 2010 was performed. A total of 104 scientific papers were retrieved initially. These were analyzed using inclusion and exclusion criteria, thus yielding nine studies for further analysis.The clinical decision support system analyzed in the present study showed a great variety of clinical problems regarding the investigation of a disease and the determination of a diagnosis. Eighty-nine per cent of the studies showed experimental models for clinical decision support system development. Seventy-eight per cent of the studies described the outcomes obtained with artificial intelligence technique. Two studies compared the clinical decision support system performance with that of a doctor, and only one research work described a controlled study evidencing improvements in the medical practice.The studies analyzed showed evidence of potential benefits that clinical decision support system can bring to the clinical practice. However, further controlled studies performed in medical day-to-day conditions and environment should be performed in order to provide more clear evidence of the usefulness of clinical decision support system in the medical practice.

Studies show a gap between the expressions commonly used by health consumers and health professionals. To bridge this gap, consumer health vocabularies are presented as a solution. The aim of this paper is to describe an on-going project to create a consumer health vocabulary (CHV) in the Brazilian Portuguese language. This project will be developed in three phases: terms extraction and connection to compose a CHV graph structure, human validation, and computacional application development. We expect to make a CHV beta version (including approximately 5,000 valid consumer terms stored in a database graph) available. This project can contribute to the improvement of CHVs.

Este estudo objetiva desenvolver um protocolo eletrônico com informações estruturadas e específicas para o atendimento e acompanhamento do paciente com doença celíaca, disponível na web, e avaliá-lo em termos de usabilidade. A estruturação dos dados clínicos foi feita por análise de formulários para consulta, prontuários e um protocolo clínico. Um protocolo para o atendimento durante a consulta para fins de diagnóstico clínico foi esquematizado e o sistema computacional web foi modelado e construído para suportar a implementação deste protocolo. Para a avaliação da usabilidade do sistema web, foi utilizado o questionário System Usability Scale (SUS). O SUS-score resultou em um valor médio de 83,5±10,0, o que indica que o sistema web foi considerado de fácil uso e de acordo com a satisfação do usuário. O sistema web implementou adequadamente o protocolo. A utilização do protocolo eletrônico mostrou-se válida para o atendimento e monitoramento do paciente com doença celíaca, pois manteve a especificidade dos dados clínicos e a rotina dos profissionais envolvidos.

Celiac disease (CD) is a difficult-to-diagnose condition because of its multiple clinical presentations and symptoms shared with other diseases. Gold-standard diagnostic confirmation of suspected CD is achieved by biopsying the small intestine.To develop a clinical decision-support system (CDSS) integrated with an automated classifier to recognize CD cases, by selecting from experimental models developed using intelligence artificial techniques.A web-based system was designed for constructing a retrospective database that included 178 clinical cases for training. Tests were run on 270 automated classifiers available in Weka 3.6.1 using five artificial intelligence techniques, namely decision trees, Bayesian inference, k-nearest neighbor algorithm, support vector machines and artificial neural networks. The parameters evaluated were accuracy, sensitivity, specificity and area under the ROC curve (AUC). AUC was used as a criterion for selecting the CDSS algorithm. A testing database was constructed including 38 clinical CD cases for CDSS evaluation. The diagnoses suggested by CDSS were compared with those made by physicians during patient consultations.The most accurate method during the training phase was the averaged one-dependence estimator (AODE) algorithm (a Bayesian classifier), which showed accuracy 80.0%, sensitivity 0.78, specificity 0.80 and AUC 0.84. This classifier was integrated into the web-based decision-support system. The gold-standard validation of CDSS achieved accuracy of 84.2% and k=0.68 (p0.0001) with good agreement. The same accuracy was achieved in the comparison between the physician's diagnostic impression and the gold standard k=0. 64 (p0.0001). There was moderate agreement between the physician's diagnostic impression and CDSS k=0.46 (p=0.0008).The study results suggest that CDSS could be used to help in diagnosing CD, since the algorithm tested achieved excellent accuracy in differentiating possible positive from negative CD diagnoses. This study may contribute towards developing of a computer-assisted environment to support CD diagnosis.

We examined the agreement between diagnoses of pigmented skin lesions based on an in-person (face-to-face) dermatological examination and diagnoses based on the study of medical records and images transferred through the web (teledermatoscopy). Two experienced dermatologists examined and diagnosed 64 pigmented skin lesions, which had been surgically excised and undergone histopathology examination. Two years later, the same cases were studied and diagnosed once again by the same dermatologists via the web. There was 72% agreement between the in-person diagnoses and the biopsy results (the gold standard), and 66% agreement between the telediagnoses and the biopsy results. Telemedicine had high sensitivity (87%) and specificity (73%), although there were 4 false-negative diagnoses. A web-based dermatoscopic diagnostic service appears to be feasible and would meet the needs for access to specialized services in rural areas. However, further work is required to decrease the number of false negative cases.