Publications Record

Selected Articles (Reverse Chronological Order)

Interactive tele-radiological segmentation systems for treatment and diagnosis

Telehealth is the exchange of health information and the provision of health care services through electronic information and communications technology, where participants are separated by geographic, time, social and cultural barriers. The shift of telemedicine from desktop platforms to wireless and mobile technologies is likely to have a significant impact on healthcare in the future. It is therefore crucial to develop a general information exchange e-medical system to enables its users to perform online and offline medical consultations through diagnosis. During the medical diagnosis, image analysis techniques combined with doctor's opinions could be useful for final medical decisions. Quantitative analysis of digital images requires detection and segmentation of the borders of the object of interest. In medical images, segmentation has traditionally been done by human experts...

More info Monograph Author:L.G.Gortzis

Int J Telemed Appl. 2012;2012:713739. doi: 10.1155/2012/713739

2012, Oct 24

Estimating the success of e-health collaborative services: the THEMIS framework

This study proposes a prototype framework (THEMIS) for estimating algebraically the success (S) of the electronic health collaborative services (e-HCS) and examines two hypotheses: first, that the S estimation of an e-HCS, developed by a third-party vendor, demands a ‘shrunk formative model’ and second that causal relationships between the involved dimensions (FFP, CO, COSTS) do exist, and their parameters affect the S – from weakly to strongly and vice-versa. A formative model was shrunk to generate three causal dimensions (‘Collaborators Objections’, ‘Costs’, ‘Fitness for Purpose’). Then, the new framework (THEMIS) was enriched with a causal loop diagram, a prototype scoring method, (termed ‘polarisation method’) and 42 questions. In order to investigate the feasibility of the THEMIS framework, we estimated the S of 15 e-HCSs and the algebraic outcomes (ES) were compared – one by one – with usage categories produced by a commercial software. Our findings supported the initial hypotheses. ...

More info Monograph Author: L.G. Gortzis

Informatics for Health and Social Care

2011, Dec 06

Coordinating effectively a heart attack pre-hospital service process using constraint optimization programming

The most crucial factor when dealing with heart attack incidents is the fast and accurate diagnosis and pre hospital service of the patient. Considering the need of handling time efficiently, emphasis is paid on the interval time management starting from the moment the incident is recognized up to the time the patient is in an emergency unit. In order to control time constraints, we propose a scheduling methodology in which the pre-hospital service is treated as a process consisted of three stages. These stages are represented by activities whose variables help us define accurately the problem. The scheduling of the activities is based on constraint optimization. A case study of five of heart attack reported incidents is analyzed and the results indicate the possible contribution of the application of this methodology...

More info Authors: C. Pylarinou, L.G. Gortzis, S. Zimeras,

Proceedings of the International Conference of Electrical and Control Engineering (ICECE), 2011, Yichang 16-18 Sept. 2011, ISBN 978-1-4244-8162-0, pp. 4752 – 4755

2011, Sept 26

Selecting Healthcare Information Systems Provided By Third-Party Vendors: A Mind Map Beyond The Manuals

The selection of a new healthcare information system (HIS) has always been a daunting process for clinicians, health care providers and policy makers. The objective of this study is to present the lessons learned and the main findings from several relevant case studies to support this process. Data were collected by retrospectively reviewing the summative results of three well-established systems, acquiring feedback from two E.U. projects, and conducting semi-structured interviews with a number of collaborators involved in electronic healthcare interventions. Selection issues were identified and classified into the following five categories: (i) data creation, (ii) data management, (iii) data sharing, (iv) data presentation and (v) modules management. A mind map was also structured to provide a more manageable list of issues concerning the most common electronic clinical technologies (e-CT)...

More info Monograph Author: L.G. Gortzis

Journal Informatics for Health and Social Care Vol. 35, No. 1, Pages 1-9

2010, Jan 02

e-Health: Are there expert patients out there?

The patients' ability to perform healthcare measurements by themselves using the information communication technologies (ICT) is a valuable variable. But are there 'expert patients' out there? The objective of the present study is to address this question. In Scenario A, participants performed measurements themselves using a portable biosignal device (PBD) in 'bedside settings'. The data collected were validated against the measurements that were performed simultaneously via the routine hospital process. In Scenario B, five participants located at their homes performed measurements by themselves and without surveillance in 'real world e-health settings'...

More info Monograph Author: L Gortzis

Journal Health Sociology Review Vol. 18 Issue 2

2009, Jul 26

Investigating the prognostic accuracy of standardized data mining algorithms in Intensive Care Unit

Modern clinicians use scalable data mining models to evaluate their hypotheses. The purpose of this paper is to present the lessons learned in solving prognostic problems in Intensive Care Unit (ICU) by using data mining models developed with standardized algorithms as an alternative solution to clinical assessment tools. The study included data from 201 ICU patients (156 male and 45 female) that were assessed by means of the APACHE II, the SOFA and the ISS as well as free thyroxin fT4, total triiodothyronine (TT3) T3, thyrotropin (TSH, corticotropin (ACTH), prolactin, cortisol and dehydroepiandrosterone sulphate (DHEAS) and the Synacthen test. We formulated three data mining models – a decision tree (DTM), a neural network (NNM), and a linear regression (LRM)- using the standardized algorithms...

More info Authors: L.G. Gortzis, F. Sakellaropoulos1, Ioannis Ilias, et al.

Journal of Computational Methods in Science and Engineering

2009, Feb 02

Digital Rights Management in Organisations: A Critical Consideration with a Socio-Technical Approach

With emerging technologies constantly creating new possibilities for organisations to manage their information resources, this chapter proposes a model for designing systems to control access to, and usage of, digital resources in organisations.The authors argue that Digital Rights Management (DRM) is a socio-technical challenge that requires a holistic approach. The resulting socio-technical forces model, titled SYNAPSIS, includes the following interdependent dimensions: Technology, Task, Structure, People, and Organisation External Forces, which act as interrelated forces.

More info Authors:[B.3] D. Pappa, L.G Gortzis

Digital Rights Management for e-Commerce Systems, Book for Idea Group ING

2009, Aug 13

Predicting ICU survival: A meta-level approach

The performance of separate Intensive Care Unit (ICU) status scoring systems vis-à-vis prediction of outcome is not satisfactory. Computer-based predictive modeling techniques may yield good results but their performance has seldom been extensively compared to that of other mature or emerging predictive models. The objective of the present study was twofold: to propose a prototype meta-level predicting approach concerning Intensive Care Unit (ICU) survival and to evaluate the effectiveness of typical mining models in this context. Data on 158 men and 46 women, were used retrospectively (75% of the patients survived). We used Glasgow Coma Scale (GCS), Acute Physiology And Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA) and Injury Severity Score (ISS) values to structure a decision tree (DTM), a neural network (NNM) and a logistic regression (LRM) model and we evaluated the assessment indicators implementing Receiver Operating Characteristics (ROC) plot analysis...

More info Authors:L.G Gortzis, F. Sakellaropoulos, I. Ilias, K. Stamoulis and I. Dimopoulou

BMC Health Services Research 2008, 8:157

2008, Aug 24

Portable biomedical devices: a critical issue during telecare services design

The selection of a portable biomedical device (PBD) is a key issue regarding telecare service design. The objective of this study is to investigate the accuracy parameters of a PBD under different settings and levels. By using a commercial PBD, trials were performed in a referral cardiology center and on the Olympia Explorer of the Royal Olympia Cruises, and the Superfast XII of Superfast Ferries. Data were collected (February 2004 – June 2006) by performing: (1) ‘in hospital’ standalone trials; (2) ‘in hospital’ comparative trials; and (3) ‘on board’ trials. Semistructured interviews were also conducted with several subjects, their cardiologists and crewmembers.We investigated the accuracy parameters...

More info Authors: L. G. Gortzis, I. Bakettas, C. Makropoulos, G. Graschew and G. Nikiforidis

Inform Health Soc Care. 2008 Jun;33(2):91-8

2008, June 26

Tracing and cataloguing knowledge in an e-health cardiology environment

In an e-health cardiology environment, the current knowledge engineering systems can support two knowledge processes; the knowledge tracing, and the knowledge cataloguing. We have developed an n-tier system capable of supporting these processes by enabling human collaboration in each phase along with, a prototype scalable knowledge engineering tactic. A knowledge graph is used as a dynamic information structure. Biosignal data (values of HR, QRS, and ST variables) from 86 patients were used; two general practitioners defined and updated the patients’ clinical management protocols; and feedback was inserted retrospectively. Several calibration tests were also performed. The system succeeded in formulating three knowledge catalogues per patient, namely, the “patient in life”, the “patient in time”, and the “patient in action”...

More info Authors:L.G. Gortzis, G. Nikiforidis

Journal of Biomedical Informatics Vol 41, (2), Pages 217–223

2008, Apr 02

Clinical Teleradiology: Collaboration over the Web During Interventional Radiology Procedures

Web-based collaborative clinical teleradiology can be looked upon as a set of services for quality assurance that enables expertise sharing and furthers health education opportunities. In particular, this set of services is a requisite of optimizing the final outcomes: structuring a common collaborative educational basis able to connect simultaneously distributed educators, students, and less experienced interventionists; eliminating the radiation dose constraints that arise from the continuous physical presence in the catheter laboratory of a high-volume center; and minimizing travel costs....

More info Monograph Author: L.G.Gortzis

Chapter in TELERADIOLOGY, Editors Sajeesh Kumar, Elizabeth Krupinski SPRINGER-VERLAG. (INVITED) (2008) ISBN: 9783540788706, pp 101-113
2008, Aug 13

Collaborative work during interventional radiological procedures based on a multicast satellite-terrestrial network

Collaboration is a key requirement in several contemporary interventional radiology procedures (IRPs). This work proposes a multicast hybrid satellite system capable of supporting advanced IRP collaboration, and evaluates its feasibility and applicability. Following a detailed IRP requirements study, we have developed a system which supports IRP collaboration through the employment of a hybrid satellite-terrestrial network, a prototype multicast version of wavelet based interactive communication system (WinVicos) application, and a partition aggregation and conditional coding (PACC) wavelet codec. A semistructured questionnaire was also used to receive evaluative feedback from collaborating participants. The departments of interventional radiology of University Hospital of Patras, Greece and of Charite Hospital of Berlin, Germany have been connected on the system...

More info Authors:Gortzis LG, Papadopoulos H, Roelofs TA, Rakowsky S, Karnabatidis D, Siablis D, Makropoulos C, Nikiforidis G, Graschew G.

IEEE Trans Inf Technol Biomed. 2007 Sep;11(5):597-9

2007, Sept 26

Designing and redesigning medical telecare services: a forces-oriented model

Medical telecare services' designing and redesigning still remains a challenging issue since it often depends on how a number of socio-technological issues are framed. This work has two key objectives; the former is to theoretically analyze the nature of a telecare environment by developing a model that reveals potential areas of analysis and the latter is to support designing and redesigning medical telecare services by formulating a strategy as well as a number of 'state of the art' guidelines.We have extended Leavitt's diamond to develop a model capable of accurately reflecting the telecare environment building dimensions as well as their interactions. This model depends on the i) technology, ii) collaborators, iii) tasks, iv) structure, v) social forces, and the vi) procedure dimensions. Taking this model as a core element we have proposed a service designing and redesigning strategy formulating, in parallel, six scalable dimension-oriented guidelines.During the two-year period (2003-2005) an enormous amount of data was collected (by active participating in two EU projects, by conducting semistructured interviews, by performing onsite observations as well as by reviewing 78 previous projects) and classified, structuring six guidelines. These guidelines can be considered as the 'state of the art' to support future services' design and redesign.This work considering the telecare environment as a multi-dimensional, operational organization has put the focus on accurate telecare services' design and redesign. The parameters are not limited, by any means, and are drawn from experience of designing services in a variety of telecare domains. The optimal parameter combination must be chosen according to the aim of each telecare procedure. Further research is needed to determine the minimum parameters to support telecare service design.

More info Monograpth Author:L.G. Gortzis

Methods Inf Med. 2007;46(1):27-35

2007, Apr 02

Optimizing the interventional cardiology facility: services integration in routine workflow

Integration of administrative and clinical data, imaging, and expert services, although challenging,is a key requirement in contemporary interventional cardiology facilities (ICF). We propose a workflow-oriented hybrid system to support the ICF and investigate its feasibility and effectiveness in a referral medical center. We have developed a Java-powered hybrid system (NetCARDIO), able to support over web synchronous and asynchronous data management, real time multimedia data telemonitoring and continuous telementoring. Data regarding procedural rates, treatment planning and radiation exposure were collected over a two-year period of routine NetCARDIO implementation(July 2002 to June 2004) and compared with data from an immediately preceding period of equal duration (January 2000 to December 2001)...

More info Authors:Gortzis L, Kalogeropoulos A, Alexopoulos D, Nikiforidis G.

Methods of Information in Medicine, 2007 (Vol. 46): Issue 3 2007

2007, Jul 02

Creating an advanced information system for supporting medical knowledge integration and management

Creating an advanced information system for supporting medical knowledge integration and management.

More info Authors: D. Pappa, L.G. Gortzis, H. Papadopoulos and L. K. Stergioulas

The British Computer Society Health Informatics Forum, ISBN 0-9546971-7-0, pp. 55-63

2007, May 24

Clinical-Oriented Collaboration Over the Web During Interventional Radiology Procedures

Multidisciplinary collaboration is a key requirement in several contemporary interventional radiology procedures (IRPs). We proposed a hybrid system (NetAngio) to enable "on the fly” heterogeneous collaboration to support IRP providing intraoperating essential services, and investigate its feasibility and effectiveness in a referral medical center. We have developed a Web-based, cost-effective structure, able to support real-time mentoring, image manipulation, and education services beyond the boundaries of the single institution and potentially allow sub specialists to participate in opinion and decision making in more complex cases. Ten interventional radiologists, two vascular surgeons and two medical physicists participated in 33 "fully collaborative” cases during a 13-month period from January 2004 to February 2005. In addition, fifteen 90-minute open seminars and finally...

More info Authors:L.G. Gortzis, D. Karnabatidis, D. Siablis, and G. Nikiforidis

Telemedicine and e-Health 12(4): 448-456. doi:10.1089/tmj.2006.12.448.

2006, Aug 24

Multi-agent cooperation infrastructure to support patient-oriented telecare services

Agent technologies are now being considered for automating tasks in e-commerce applications. However, conventional agent modules with predefined functions, but without the ability to modify behavior dynamically, may be too limited for mediating telecare medical services properly, since they cannot switch roles or adjust their behavior to support dynamically-formed healthcare systems. In this paper we propose a design and an implementation of an infrastructure that is able to collect and analyze large amount of heterogeneous data to support patient-oriented telecare services. We have constructed a Java-based dynamic infrastructure that utilizes XML-formatted data to enable dynamic behavior modification of agent...

More info Authors: V. Poulopoulos, L.G. Gortzis, I. Bakettas, G. Nikiforidis,

Proceedings of the 4th IEEE International Conference on Information Technology: Research and Education-ITRE, Tel Aviv, Israel, October 2006, Page(s):253–257, doi: 10.1109/ITRE.2006.381576
2006, Oct 24

Legal and clinical risk assessment guidelines in emerging M-health systems

Recognising the growing importance of mobile health for providing medical services and improving the quality of life and the right of patients to quality care, this paper presents a guidance on how legal and clinical risk should be addressed and managed when medical practice involves the use of mobile-health systems. To this end, we investigate clinical and legal risks that may result from the application of mobile health systems, looking (a) into the behaviour of healthcare practitioners in the mobile setting, (b) into the management of supporting medical information and data and (c) the effect of the operating environment (context). The objective is to assist those that are involved, use or manage mobile-health systems in exploiting the capabilities of such systems, and in identifying and overcoming their limitations in an operational setting...

More info Authors: H. Papadopoulos, D. Pappa and L.G. Gortzis

Proceedings of the IEEE International Conference on Information Technology in Biomedicine

2006, Oct 20

Clinical-oriented Collaborative Work over web during endourology

Endourological Procedures (EP) usually demand application of several diagnostic and therapeutic methods in order to succeed and therefore the ad-hoc collaboration of various hospital specializations are required. The objective of the presented work is to offer a combined solution for supporting high quality imaging services, sharing knowledge and improving therapeutic outcomes through a web-based integrated system. Materials and methods: A web-based hybrid system, called NetUro, has been designed to support collaborative clinical-oriented services (e.g. mentoring, image processing and education) during EP; especially in high-complexity procedures where the simultaneous presence of a remote endourology expert and/or a medical physicist or an interventional radiologist are required...

More info Authors:E. Liatsikos, L. G. Gortzis, A. Athanasopoulos , P. Perimenis, G. Barbalias, G. Nikiforidis

Procedures, Journal of Endourology, 19: supplement 1, a287-a303y

2005, Dec 04

Design and implementation of a web-enabled haematological system

This paper describes the design and the implementation of a web-enabled integrated haematological system, named e-HS. The proposed system runs on a set of distributed network nodes providing useful haematological services. These services include patient-oriented data management, digitized histopathological slides (DHS) acquisition, teleconsulting facilities, etc.The objective of e-HS is to supply web-enabled services according to haematological requirements, implement a distributed storage scheme for DHS, and provide a common database containing all haematological laboratory results by using eXtensible Markup Language (XML) and web technologies. Our implementation can be accessible to every authorized physician at the distributed nodes without any additional software.

More info Authors: L.G. Gortzis, S. Koubias, G. Nikiforidis

Computer Methods and Programs in Biomedicine, Volume 75, Issue 3, Pages 221–234

2004, Sept 04

Tele-diagnostic and Therapeutic Guidance in Urology

To design a Web-based network for diagnostic and therapeutic guidance in urology.We designed an architectural model of a low-cost multimedia Web platform that runs on a collection of distributed collaborative network nodes to provide a set of urologist-oriented Web-enabled services. Any node of the platform was able to share patient-oriented data via automated processes with appropriate authorization, confidentiality, and high-security protocols. The urologist can show the details of the records of patients and additionally enrich the world experience with his or her own cases. Video clips maintained locally at the nodes will be accessible by clinicians in a trouble-free way

More info Authors: E. Liatsikos L.G. Gortzis, Nikiforidis, G Barbalias

Journal of Endourology Volume: 18 Issue 7

2004, Oct 02

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