Aim: to examine the opinions of healthcare professionals on using codes from the ICD-10 group chronic ischemic heart disease (CIHD) (I25.0, I25.1, I25.8, I25.9) as the primary cause of death and discuss the results in the context of comparing with regional variability of standardized mortality ratio (SMR) from different forms of CIHD.
Materials and methods. A one-stage study was conducted. This article describes the results of a survey of 366 medical workers (cardiologists, internists/general practitioners/family doctors, pathologists, public health and healthcare specialists, paramedics) from 47 subjects of the Russian Federation who fill out a medical death certificate (MDS) more often than 2–3 times a month. In addition, SMR from coronary heart disease were determined based on a brief nomenclature of causes of death of Rosstat in 82 regions of the Russian Federation for 2022.
Results. 80.1 % of respondents expressed the opinion that I25.0, I25.1, I25.8, I25.9 are necessary for coding causes of death, but half of those surveyed do not see any differences in them. At the same time, respondents admit the possibility of using these CIHD codes as the primary cause of death without ante-mortem and pathological verification. The relatively small coefficient of variation of SMR overall from CIHD (34.19 per 100,000 population) is associated with high values from its individual forms: the coefficient of variation of average regional SMRs ranged from 62 % for code I25.1 to 174 % for code I25.0.
Conclusions. The results of this study indicate a variable attitude of specialists filling out MSD towards choosing ICD-10 codes from the CIHD group, leading to significant interregional differences in CIHD mortality rates. It is necessary to develop unified recommendations describing situations in which codes from the CIHD group can be considered the primary (main) cause of death.

Introduction. Healthcare is one of the priority sectors for the deployment of artificial intelligence (AI) technologies worldwide, including Russia. A key area of AI deployment is the integration of AI-base software as a medical device (AI SaMD) into the Unified digital systems of the healthcare sector of the Russian Federation.
Aim. Research of the results of the deployment of AI SaMD in healthcare of the Russian Federation in 2023.
Materials and methods. The State Register of Medical Devices and Organizations (individual entrepreneurs) engaged in the production and manufacture of medical devices was used as information about AI SaMD registered in Russia. As information on the deployment of AI SaMD, data from monitoring to the federal project “Creating a single digital system in healthcare” was used, including reports from constituent entities of the Russian Federation upon these activities. The results of the implementation of AI SaMD in Moscow were obtained according to data from the Moscow Department of Health as part of an experiment on the use of innovative technologies in the field of computer vision for the analysis of medical images.
Results. As of January 1, 2024, Roszdravnadzor registered 26 AI SaMD, 77 % of them were developed by 13 Russian companies. At the end of 2023, 84 (94 %) constituent entities of the Russian Federation met the minimum established target for the purchase of AI SaMD. Within the framework of public procurement procedures provided by law, 106 government contracts were signed for the purchase and deployment of AI SaMD for a total amount of 448 million 430 thousand rubles.
Conclusion. In 2023, the Russian healthcare system made a significant breakthrough in terms of the practical deployment of AI SaMD. Completed procurement and deployment projects are the basis for subsequent industry development.

The growth of digitalization in medicine has significantly expanded the possibilities of using big data in pharmacoepidemiology. The use of big data makes it possible to reduce the cost of clinical research, increase the speed of recruitment and expand the sample, makes it possible to evaluate the effect of drugs in pregnant women and effectiveness in rare diseases. The databases PubMed, Scopus, Web of Science and Google Scholar for 12 years from 2012 to 2023, United Nations documents, World Health Organization, Federal laws of the Russian Federation in the field of artificial intelligence, protection of confidential information, and clinical research were analyzed. The search was carried out by keywords: «big data», «registers», «pharmacoepidemiology», «personal data», «legal regulation», «protection methods». The article provides examples of the use of big data in healthcare, including from 25 to 50 million people. The analysis of the literature data revealed the same type of problems – the lack of uniformity in the introduction of information, incomplete information, limited availability. The review identifies the problems of protecting the confidentiality of information. The mechanisms of information standardization, storage, and data processing are considered. The international and Russian legislative framework regulating the conduct of clinical trials using big data is presented.

The article presents the experience of the «National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov» in creation of medical guidelines based on the patient’s route business process for vertically integrated medical information system for “Obstetrics and gynecology” and “Neonatology” (VIMIS “AKiNEO”), with simultaneous digitization of the document, describes the advantages of this an approach before the classical form of writing document.
Aim. To conduct a comparative analysis of approaches to writing a medical guideline based on a digitized medical guideline and patient’s route business process for VIMIS “AKiNEO” and in the classical way.
Materials and methods. The content of digitized medical guidelines and procedures for the provision of medical care, formed by experts on the basis of the “National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov” with the methodological support of the Center for Healthcare Quality Assessment and Control were used. The assessment of the methodological advantages of writing medical guidelines based on patient routes business processes in comparison with writing in the classical way was carried out using methods of analysis and synthesis.
Results. Experts have created 17 patient routes using the content of digitized medical guidelines for immersion in the VIMIS “AKiNEO”. These routes fully reflect the amount and timing of medical interventions necessary to ensure the quality of medical care. Methodological approaches for writing medical guidelines based patient routes business processes have been developed. It has been demonstrated that digitizing the content of medical guidelines and medical care procedures, describing medical guidelines in the form of a business process diagram, identify “zones of uncertainty” that ar e not visible in the text document, and can significantly affec t the quality of medical care to the patient.
Conclusion. The creation of regulatory legal acts on the organization and provision of medical care and medical guidelines in modern conditions of healthcare digital transformation should take place after digitizing the text of the document and creating a business process for the patient’s route, which will improve the quality of these documents.

Pre-professional medical education in high school provides not only a more in-depth study of individual subjects of general education programs, but also expands the opportunities for self-determination of students, ensures continuity of the educational process, allows boys and girls to adapt more successfully mastering higher medical professional education programs and is the basis for a successful career.
Aim. To evaluate the results of the introduction and implementation of the model of pre-professional medical and pharmaceutical education using the example of the Resource Center «Medical Sechenov Pre-University» of the Sechenov First Moscow State Medical University (Sechenov University) (hereinafter referred to as the Pre-University) as a means of developing the human resources potential of the healthcare system on the territory of the Russian Federation.
Materials and methods. During the work, a theoretical analysis of domestic and foreign literature on the problem of developing the human resources potential of the healthcare system was carried out. A study was conducted in the comparative aspect of the basic readiness of students in grades 8-11 at the Pre-University and specialized medical and biological classes of regional educational institutions to the choice of medical specialties using a test questionnaire with the identification of three key aspects: readiness to master medical specialties; self-assessment of capabilities and erudition in the field of modern medicine. 1465 people took part in the survey. The reliability of the results was carried using the Mann-Whitney U test. Assessment of the statistical significance of differences between the means was carried out at a critical level of p = 0.05.
Results. Studying at the Pre-University of Sechenov University allowed the majority of adolescents to achieve higher levels of formation of the main indicators of basic readiness to choose medical specialties. The share of students with a high level of readiness to master medical specialties at the Pre-University is 13.8 % higher compared to students of specialized medical and biological classes, with high erudition – 13.8 % and 6.7 % higher those who highly assess their prospects for entering a medical university.
Conclusion. Pre-professional education based on close interaction between the Pre-University and Sechenov University allows students to develop motivation to choose a medical profession, as well as a clear understanding of the learning process in the chosen profession and is an important link in the system of continuous educational trajectory «pre-university–university–clinic».