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This book constitutes the refereed proceedings of the 4th International Symposium on Medical Data Analysis, ISMDA 2003, held in Berlin, Germany in October 2003.§The 15 revised full papers presented were carefully reviewed and selected for inclusion in the book. The papers are organized in topical sections on medical models and learning, integration of intelligent analysis methods into medical databases, medical signal processing and image analysis, and applications of medical diagnostic support systems.