This site will be dedicated to my efforts to create apps and programming libraries that deliver medical decision support.
The MetaVision Copy Tool
In the intensive care unit of the hospital where I work (the University Medical Center Utrecht), we rely on a Patient Data Management System (PDMS) called MetaVision. This system stands out for its exceptional configurability, making it an invaluable tool. With MetaVision, we have the ability to define and fine-tune various aspects, allowing for a truly customized system. The fundamental building block of this system is a parameter, which can be displayed and utilized across menus, graphs, tables, forms, and more. These parameters can store various data types, including text, numbers, dates, and more. Additionally, VB.NET scripts can be employed to further enhance and extend the functionality of these parameters.
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Trees
A tree is a very common datastructure. I stumbled upon this subject because of a requirement that is needed for a mathematical solution. This solution needs to keep track of changes that start with a single change but can have multiple effects. Each effect, i.e. change, can result in turn into multiple changes, hence the need of a tree structure.
Feliz React components
I have been looking for a best practice to create a major single page application using the excellent Feliz library. I also heavily borrowed ideas from a book by the author of Feliz, Zaid Ajaj. The application in mind is intended to be the Dutch National Pediatric Emergency app used for acute interventions in pediatric medical emergencies. The main purpose of the application is to provide all calculations necessary based on age and weight of the patient.
Informedica Software Development
Software development for Informedica has been a one man show. Maybe that’s about to change. However, this means that the development process has to change as well. In this blog I propose a development process to enable this change. The fork and pull model will be used to cooperate.
Hoe kunnen wij kritisch zieke kinderen (nog) optimaal(-er) behandelen over 5 jaar?
Waarom?
Het ergste wat een ouder kan overkomen is dat zijn/haar kind kritisch levensbedreigend ziek wordt. De Kinder IC is dan vaak de laatste strohalm. Gelukkig wordt de behandeling steeds beter op de IC, maar daarmee worden ook de uitdagingen steeds groter. Een zeer belangrijke uitdaging daarbij is groeiende complexiteit van zorg die geleverd moet worden aan toenemend complexe patiënten.
The case for a Generalized Computerized Provider Order Entry system: GenPRES
What is the problem?
To Err is Human. This is how a landmark paper from 2000 starts, recognizing that “the problem is not bad people in health care–it is that good people are working in bad systems that need to be made safer“*. The consequences of errors can be described by adverse events. Adverse events that are related to medication and or drug/fluid incidents constitute about 20% of all types of adverse events, which makes this the second most common type of adverse event†.
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PICURED Pediatric Intensive Care Research Database
At the PICU (Pediatric Intensive Care Unit) of the University Medical Center Utrecht, we have been working the last years to make the data from our PDMS (Patient Data Management System) available for research. This has resulted in a multilayered system with generic possibilities to extract data and transform those data into a convenient flat table format (as described in a previous post).
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Machine Learning in Pediatric Critical Care
Machine Learning (ML) (or Artificial Intelligence AI) is trending. Publications with regard to ML are on the increase in medical literature.
Specifically critical care medicine generates huge amounts of detailed data. In a recent article steps are described to enable use of ML in daily clinical practice. This blog will describes an actual working implementation of the first step in ML to be used in clinical practice.

Mamdani, M., & Slutsky, A. S. (2020). Artificial intelligence in intensive care medicine. Intensive Care Medicine, 47(2), 147–149. http://doi.org/10.1007/s00134-020-06203-2
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Feliz indentation and Fantomas
Indentation is important in F#, as it defines the code blocks and the separate code elements. Using Feliz to define a view, in a Fable.React application, the indentation matters just as much, and even more.
Fantomas is a beautiful tool that automatically formats your code and ensures consistency, also in indentation. But using code like with the Feliz library, there some serious drawbacks.
Machine Learning Feature Selection
In a previous post, a setup using an F# script to perform machine learning with Microsoft.ML is described. A very import aspect for a successful model is picking the right features that will predict the label, i.e. the exposure that is associated with outcome. In this post a simple F# feature selection algorithm is described that automatically figures out which features result in the ‘best’ model.