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1.
Weakly-supervised multilingual medical NER for symptom extraction for low-resource languages
Rigon Sallauka, Umut Arioz, Matej Rojc, Izidor Mlakar, 2025, original scientific article

Abstract: Patient-reported health data, especially patient-reported outcomes measures, are vital for improving clinical care but are often limited by memory bias, cognitive load, and inflexible questionnaires. Patients prefer conversational symptom reporting, highlighting the need for robust methods in symptom extraction and conversational intelligence. This study presents a weakly-supervised pipeline for training and evaluating medical Named Entity Recognition (NER) models across eight languages, with a focus on low-resource settings. A merged English medical corpus, annotated using the Stanza i2b2 model, was translated into German, Greek, Spanish, Italian, Portuguese, Polish, and Slovenian, preserving the entity annotations medical problems, diagnostic tests, and treatments. Data augmentation addressed the class imbalance, and the fine-tuned BERT-based models outperformed baselines consistently. The English model achieved the highest F1 score (80.07%), followed by German (78.70%), Spanish (77.61%), Portuguese (77.21%), Slovenian (75.72%), Italian (75.60%), Polish (75.56%), and Greek (69.10%). Compared to the existing baselines, our models demonstrated notable performance gains, particularly in English, Spanish, and Italian. This research underscores the feasibility and effectiveness of weakly-supervised multilingual approaches for medical entity extraction, contributing to improved information access in clinical narratives—especially in under-resourced languages.
Keywords: low-resource languages, machine translation, medical entity extraction, NER, NLP, patient-reported outcomes, weakly-supervised learning
Published in DKUM: 19.05.2025; Views: 0; Downloads: 1
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2.
Evaluating the benefits and implementation challenges of digital health interventions for improving self-efficacy and patient activation in cancer survivors : single-case experimental prospective study
Umut Arioz, Urška Smrke, Valentino Šafran, Maja Ravnik, Matej Horvat, Vojko Flis, Izidor Mlakar, 2025, original scientific article

Abstract: Cancer survivors face numerous challenges, and digital health interventions can empower them by enhancing self-efficacy and patient activation. This prospective study aimed to assess the impact of a mHealth app on self-efficacy and patient activation in 166 breast and colorectal cancer survivors. Participants received a smart bracelet and used the app to access personalized care plans. Data were collected at baseline and follow-ups, including patient-reported outcomes and clinician feedback. The study demonstrated positive impacts on self-efficacy and patient activation. The overall trial retention rate was 75.3%. Participants reported high levels of activation (PAM levels 1–3: P = 1.0; level 4: P = 0.65) and expressed a willingness to stay informed about their disease (CASE-Cancer factor 1: P = 0.98; factor 2: P = 0.66; factor 3: P = 0.25). Usability of the app improved, with an increase in participants rating the system as having excellent usability (from 14.82% to 22.22%). Additional qualitative analysis revealed positive experiences from both patients and clinicians. This paper contributes significantly to cancer survivorship care by providing personalized care plans tailored to individual needs. The PERSIST platform shows promise in improving patient outcomes and enhancing self-management abilities in cancer survivors. Further research with larger and more diverse populations is needed to establish its effectiveness.
Keywords: cancer survivorship, self-efficacy, satisfaction, patient activation, digital health interventions
Published in DKUM: 25.04.2025; Views: 0; Downloads: 0

3.
Perceptions of patient safety culture among triage nurses in the emergency department : a cross-sectional study
Zvonka Fekonja, Sergej Kmetec, Nataša Mlinar Reljić, Jožica Černe Kolarič, Majda Pajnkihar, Matej Strnad, 2023, original scientific article

Abstract: The patient safety culture is key to ensuring patient safety in healthcare organizations. The triage environment is inherently demanding for patient safety and is characterized by high stress, rapid decision-making, and quick action. In several countries, including Slovenia, there is a lack of studies on the patient safety culture among triage nurses. This study aimed to assess the perceptions of the patient safety culture among triage nurses. A cross-sectional survey design was used. The Emergency Medical Services-Safety Attitudes Questionnaire, distributed to triage nurses, was used to collect data. A total of 201 triage nurses participated in this study. The results revealed that the overall average perception of the patient safety culture was 57.27% (SD = 57.27), indicating that the perception of the patient safety culture among triage nurses in the emergency department was non-positive and requires improvement. “Job Satisfaction” received the highest score (63.18%; SD = 17.19), while “Working Conditions” received the lowest (49.91%; SD = 17.37). The perception of positive and negative safety culture responses was statistically significant for age (χ2 (3) = 17.750, p ≤ 0.001), education (χ2 (2) = 6.957, p = 0.031) and length of working experience (χ2 (3) = 8.875, p = 0.031). The findings emphasize the significance of improving the safety culture in relation to several areas of patient care during the triage process. This research serves as a crucial foundation for enhancing patient safety in triage, providing quality care, and reducing adverse events.
Keywords: triage, patient safety, perception, safety management, emergency medical services
Published in DKUM: 07.04.2025; Views: 0; Downloads: 1
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4.
Radiotherapy department supported by an optimization algorithm for scheduling patient appointments
Marcela Chavez, Silvia Gonzalez, Ruiz Alvaro, Duflot Patrick, Nicolas Jansen, Izidor Mlakar, Umut Arioz, Valentino Šafran, Philippe Kolh, Van Gasteren Marteyn, 2025, original scientific article

Abstract: Prompt administration of radiotherapy (RT) is one of the most effective treatments against cancer. Eachday, the radiotherapy departments of large hospitals must plan numerous irradiation sessions, con-sidering the availability of human and material resources, such as healthcare professionals and linearaccelerators. With the increasing number of patients suffering from different types of cancers, manuallyestablishing schedules following each patient’s treatment protocols has become an extremely difficultand time-consuming task. We propose an optimization algorithm that automatically schedules andgenerates patient appointments. The model can rearrange fixed appointments to accommodate urgentcases, enabling hospitals to schedule appointments more efficiently. It respects the different treatment Prompt administration of radiotherapy (RT) is one of the most effective treatments against cancer. Eachday, the radiotherapy departments of large hospitals must plan numerous irradiation sessions, con-sidering the availability of human and material resources, such as healthcare professionals and linearaccelerators. With the increasing number of patients suffering from different types of cancers, manuallyestablishing schedules following each patient’s treatment protocols has become an extremely difficultand time-consuming task. We propose an optimization algorithm that automatically schedules andgenerates patient appointments. The model can rearrange fixed appointments to accommodate urgentcases, enabling hospitals to schedule appointments more efficiently. It respects the different treatment.
Keywords: appointments, hospital management, optimization algorithm, patient satisfaction, planning, radiotherapy
Published in DKUM: 25.02.2025; Views: 0; Downloads: 8
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5.
Dojemanje oskrbe, osredotočene na pacienta, v treh klinikah za zdravljenje neplodnosti : vpliv zdravljenja v domačem okolju ali tujini in povračila stroškov
Veljko Vlaisavljević, Borut Kovačič, 2024, original scientific article

Abstract: Namen te študije je bil oceniti izkušnje bolnikov z oskrbo, osredotočeno na bolnika (PCC), na treh klinikah za zdravljenje neplodnosti glede na kritje stroškov zdravljenja in kraj, kjer so bili zdravljeni.
Keywords: assisted reproductive therapy, cross-border patients, patient treatment experience, patient centeredness, quality of care
Published in DKUM: 07.01.2025; Views: 0; Downloads: 21
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6.
Long-term impact of community psychiatric care on quality of life amongst people living with schizophrenia : a systematic review
Jožica Černe Kolarič, Anja Plemenitaš Ilješ, Darja Kraner, Vida Gönc, Mateja Lorber, Nataša Mlinar Reljić, Zvonka Fekonja, Sergej Kmetec, 2024, review article

Abstract: The review examines the long-term impact of community psychiatric care on improving the quality of life of people with schizophrenia. It addresses the global burden of this disorder and the need for effective community-based care strategies. A systematic literature search was conducted in databases such as CINAHL, Medline, Web of Science, Sage and ScienceDirect, with the search lasting until March 2024 and following the PRISMA guidelines. The inclusion criteria targeted studies that addressed the long-term effects of community mental health care for people aged 18 years and older with schizophrenia and included both quantitative and qualitative research designs. Studies unrelated to the research question or with significant methodological flaws were excluded. The risk of bias was assessed using GRADE and GRADECERqual, in addition to critical appraisal using the Joanna Briggs Institute (JBI) checklists. Independent screening and data extraction was performed, with results summarised by thematic analysis. In total, 11 studies met the inclusion criteria and included cross-sectional, cohort, qualitative and randomised controlled trial designs. The results showed that community psychiatric care significantly improves the quality of life, well-being and social integration of people with schizophrenia. Effective interventions identified include psychoeducation, cognitive behavioural therapy, social skills training and individualised care plans. However, challenges such as limited resources, labour shortages and social stigma, particularly in low-income neighbourhoods, were also identified. This study highlights the importance of continuous, personalised, multidisciplinary community-based care for sustainable mental health outcomes. Further research is recommended to investigate the long-term impact and strategies to overcome implementation challenges.
Keywords: schizophrenia, quality of life, community, psychiatric care, patient, systematic review
Published in DKUM: 22.11.2024; Views: 0; Downloads: 11
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7.
The safety culture of the Ljubljana community health centre's employees
Špela Tevžič, Tonka Poplas-Susič, Zalika Klemenc-Ketiš, 2021, original scientific article

Abstract: Introduction: Patient safety is one of the key aspects of healthcare quality and a serious global public health concern. Patient safety culture is a part of the patient safety concept. In Slovenia, primary care is easily accessible, and for medical care, it serves as a gatekeeper to hospital care. For several years, the quality and safety at the primary healthcare level have been the focus of several studies. The present study aimed to assess patient safety culture among all employees of the Community Health Centre Ljubljana. Methods: We conducted a cross-sectional study in 2017 using the Slovene version of “Medical Office Survey on Patient Safety Culture” from the Agency for Healthcare Research and Quality. Mean percent positive scores on all items in each composite were calculated according to a user guide. Results: The final sample contained 1021 participants (67.8% response rate), of which 909 (89.0%) were women. The mean age of the sample was 43.0±11.0 years. The dimensions most highly rated by the respondents were: teamwork and patient care tracking/follow-up. The lowest scores came from leadership support for patients’ safety and work pressure and pace. Conclusion: Patient safety culture in the Community Health Centre Ljubljana is high, but there are certain areas of patient safety that need to be evaluated further and improved. Our study revealed differences between professions, indicating that a customized approach per profession group might contribute to the successful implementation of safety strategies. Patient safety culture should be studied at national levels.
Keywords: patient safety, safety culture, family medicine, primary healthcare, Slovenia
Published in DKUM: 18.10.2024; Views: 0; Downloads: 5
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8.
Multilingual framework for risk assessment and symptom tracking (MRAST)
Valentino Šafran, Simon Lin, Jama Nateqi, Alistair G. Martin, Urška Smrke, Umut Arioz, Nejc Plohl, Matej Rojc, Dina Běma, Marcela Chavez, Matej Horvat, Izidor Mlakar, 2024, original scientific article

Abstract: The importance and value of real-world data in healthcare cannot be overstated because it offers a valuable source of insights into patient experiences. Traditional patient-reported experience and outcomes measures (PREMs/PROMs) often fall short in addressing the complexities of these experiences due to subjectivity and their inability to precisely target the questions asked. In contrast, diary recordings offer a promising solution. They can provide a comprehensive picture of psychological well-being, encompassing both psychological and physiological symptoms. This study explores how using advanced digital technologies, i.e., automatic speech recognition and natural language processing, can efficiently capture patient insights in oncology settings. We introduce the MRAST framework, a simplified way to collect, structure, and understand patient data using questionnaires and diary recordings. The framework was validated in a prospective study with 81 colorectal and 85 breast cancer survivors, of whom 37 were male and 129 were female. Overall, the patients evaluated the solution as well made; they found it easy to use and integrate into their daily routine. The majority (75.3%) of the cancer survivors participating in the study were willing to engage in health monitoring activities using digital wearable devices daily for an extended period. Throughout the study, there was a noticeable increase in the number of participants who perceived the system as having excellent usability. Despite some negative feedback, 44.44% of patients still rated the app’s usability as above satisfactory (i.e., 7.9 on 1–10 scale) and the experience with diary recording as above satisfactory (i.e., 7.0 on 1–10 scale). Overall, these findings also underscore the significance of user testing and continuous improvement in enhancing the usability and user acceptance of solutions like the MRAST framework. Overall, the automated extraction of information from diaries represents a pivotal step toward a more patient-centered approach, where healthcare decisions are based on real-world experiences and tailored to individual needs. The potential usefulness of such data is enormous, as it enables better measurement of everyday experiences and opens new avenues for patient-centered care.
Keywords: multilingual framework, risk assessment, symptom tracking, chronic diseases, patient-centered care, real-world data
Published in DKUM: 12.08.2024; Views: 74; Downloads: 15
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9.
Core values of family medicine in Europe : current state and challenges
Eva Arvidsson, Igor Švab, Zalika Klemenc-Ketiš, 2021, original scientific article

Abstract: Background: Values are deeply held views that act as guiding beliefs for individuals and organizations. They state what is important in a profession. The aims of this study were to determine whether European countries have already developed (or are developing) documents on core values in family medicine; to gather the lists of core values already developed in countries; and to gather the opinions of participants on what the core family values in their countries are. Methods: This was a qualitative study. The questionnaire was distributed as an e-survey via email to present and former members of the European Society for Quality and Safety in Family Practice (EQuiP), and other family medicine experts in Europe. The questionnaire included six items concerning core values in family medicine in the respondent's country: the process of defining core values, present core values, the respondents' suggestions for core values, and current challenges of core values. Results: Core values in family medicine were defined or in a process of being defined in several European countries. The most common core values already defined were the doctor-patient relationship, continuity, comprehensiveness and holistic care, community orientation, and professionalism. Some countries expressed the need for an update of the current core values' list. Most respondents felt the core values of their discipline were challenged in today's world. The main values challenged were continuity, patient-centered care/the doctor-patient relationship and comprehensive and holistic care, but also prioritization, equity, and community orientation and cooperation. These were challenged by digital health, workload/lack of family physicians, fragmentation of care, interdisciplinary care, and societal trends and commercial interests. Conclusion: We managed to identify suggestions for core values of family medicine at the European level. There is a clear need to adopt a definition of a value and tailor the discussion and actions on the family medicine core values accordingly. There is also a need to identify the core values of family medicine in European countries. This could strengthen the profession, promote its development and research, improve education, and help European countries to advocate for the profession.
Keywords: value orientation, family practice, continuity of patient care, patient-centered care, Europe
Published in DKUM: 06.08.2024; Views: 109; Downloads: 12
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10.
Safety culture and the positive association of being a primary care training practice during COVID-19 : the results of the multi-country European PRICOV-19 study
Bianca Silva, Zlata Ožvačić Adžić, Pierre Vanden Bussche, Esther Van Poel, Bohumil Seifert, Cindy Heaster, Claire Collins, Canan Tuz Yilmaz, Felicity Knights, Zalika Klemenc-Ketiš, 2022, original scientific article

Abstract: The day-to-day work of primary care (PC) was substantially changed by the COVID-19 pandemic. Teaching practices needed to adapt both clinical work and teaching in a way that enabled the teaching process to continue, while maintaining safe and high-quality care. Our study aims to investigate the effect of being a training practice on a number of different outcomes related to the safety culture of PC practices. PRICOV-19 is a multi-country cross-sectional study that researches how PC practices were organized in 38 countries during the pandemic. Data was collected from November 2020 to December 2021. We categorized practices into training and non-training and selected outcomes relating to safety culture: safe practice management, community outreach, professional well-being and adherence to protocols. Mixed-effects regression models were built to analyze the effect of being a training practice for each of the outcomes, while controlling for relevant confounders. Of the participating practices, 2886 (56%) were non-training practices and 2272 (44%) were training practices. Being a training practice was significantly associated with a lower risk for adverse mental health events (OR: 0.83; CI: 0.70-0.99), a higher number of safety measures related to patient flow (Beta: 0.17; CI: 0.07-0.28), a higher number of safety incidents reported (RR: 1.12; CI: 1.06-1.19) and more protected time for meetings (Beta: 0.08; CI: 0.01-0.15). No significant associations were found for outreach initiatives, availability of triage information, use of a phone protocol or infection prevention measures and equipment availability. Training practices were found to have a stronger safety culture than non-training practices. These results have important policy implications, since involving more PC practices in education may be an effective way to improve quality and safety in general practice.
Keywords: safety culture, patient safety, quality of care, primary health care, COVID-19, medical education, vocational training, PRICOV-19, infectious disease, multi-country, general practice
Published in DKUM: 04.07.2024; Views: 128; Downloads: 17
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