Unambiguous identification of hospital patients: case study at the university departments of the General Hospital, Vienna.

This article considers the problem of identifying patients in one or more heterogeneous personal databases. The unambiguous identification of patients is an essential prerequisite for an efficient patient care system. We discuss the problems involved in this task and suggest how they can be dealt with. The solution of automatic consolidation of patient records sequires programming, organisational and work psychology measures. Following a survey of conventional identification methods, the method developed at the Department of Medical Computer Sciences, which is based on the current clinical situation at the General Hospital in Vienna (AKH--Allgemeines KrankenHaus), is described in detail. The basic principle is to identify patients unambiguously by means of an ID (IZAHL) derived directly from the personal data. Thereby a deterministic technique without probability weighting is used-all compared information must correspond completely. The article closes with a critical survey of experience gathered to date.

[Use of the computer in clinical medicine]. / Computereinsatz in der klinischen Medizin.

This article describes the application of computers in clinical medicine and the experience gained by the Institute of Medical Computer Science when introducing computer systems into the clinics of the University of Vienna Medical School in the last 20 years. It is shown what dramatic development has taken place in these years. The medical information system WAMIS with its central patient database is described as well as the medical record keeping documentation and retrieval system WAREL, which is destined to analyze medical natural language data. A further chapter deals with computers in clinical laboratories. At the end it is tried to point out future trends in applying computers in clinical medicine.

[Medical expert and consultation systems: review and examples for their use]. / Medizinische Experten- und Konsultationssysteme: Uberblick und Anwendungsbeispiele.

After a general introduction into the area of medical expert and consultation systems, a survey about different types of medical expert systems is given. The different objectives and modes of application of medical expert systems are presented and explained in detail. In the second part of this paper, the applicability of computer systems for fully automated interpretation of hepatitis serology findings in the clinical laboratory and for aiding differential diagnosis in internal medicine is described. With the examples given, it is demonstrated that expert systems for clinical decision aid can be of great benefit for the physician in the hospital or the doctor's office.

[Acute viral encephalitis with primary psychotic symptoms--diagnosis, course and prognosis]. / Akute virale Enzephalitis mit primär psychotischer Symptomatik--Diagnose, Verlauf und Prognose.

In 13 cases referred to psychiatric treatment between 1974 and 1980 acute viral encephalitis was diagnosed in the further course of the illness. The majority were female patients. Positive virological or pathological evidence was obtained in 38% of all cases. The most frequent etiology to be found was the herpes-simplex virus. These findings correspond to 36 cases from the literature. 90% of all cases showed neurological symptoms within two weeks of hospital admission. EEG and cerebrospinal fluid examinations proved to yield most in diagnosis, whereas angiography and brain scanning did not have special diagnostic importance. The present diagnostic value of CT is mainly restricted to the detection of herpes-simplex virus encephalitis and acute leukoencephalitis. Initially psychopathological findings varied largely and fluctuations in the level of consciousness were a prominent feature in most cases. In others no difference to schizophrenic psychosis could be noted on admission. Compared to other studies on acute viral encephalitis with initial neurological symptoms, patients with a psychotic onset of the illness tend to have a higher morbidity, while the mortality remains the same.

[Diagnostic key for intensive care patients: combination of clinical parameters with laboratory findings]. / Diagnoseschlüssel für Intensivpatienten: Kombination klinischer Befunde mit Laboratoriumsbefunden.

A new diagnostic key has been established based on the reports of 3845 critically ill patients in our medical intensive care unit. The clinical diagnoses in these patients were classified in 22 different groups according to different organs or etiological entities (diseases of the liver, infectious diseases, intoxications etc.). 42 different laboratory parameters were selected for classification of metabolic or organ-related complications. Combining of clinical diagnoses with laboratory values characterizes the seriously ill patient. Our new system proved to be practicable in describing the degree, complications and prognosis of disorders in intensive care medicine. The results are demonstrated in patients with hepatic coma.