Personalized conciliation of clinical guidelines for comorbid patients through multi-agent planning

[EN] The conciliation of multiple single-disease guidelines for comorbid patients entails solving potential clinical interactions, discovering synergies in the diagnosis and the recommendations, and managing clinical equipoise situations. Personalized conciliation of multiple guidelines considering additionally patient preferences brings some further difficulties. Recently, several works have explored distinct techniques to come up with an automated process for the conciliation of clinical guidelines for comorbid patients but very little attention has been put in integrating the patient preferences into this process. In this work, a Multi-Agent Planning (MAP) framework that extends previous work on single-disease temporal Hierarchical Task Networks (HTN) is proposed for the automated conciliation of clinical guidelines with patient-centered preferences. Each agent encapsulates a single-disease Computer Interpretable Guideline (CIG) formalized as an HTN domain and conciliates the decision procedures that encode the clinical recommendations of its CIG with the decision procedures of the other agents' CIGs. During conciliation, drug-related interactions, scheduling constraints as well as redundant actions and multiple support interactions are solved by an automated planning process. Moreover, the simultaneous application of the patient preferences in multiple diseases may potentially bring about contradictory clinical decisions and more interactions. As a final step, the most adequate personalized treatment plan according to the patient preferences is selected by a Multi-Criteria Decision Making (MCDM) process. The MAP approach is tested on a case study that builds upon a simplified representation of two real clinical guidelines for Diabetes Mellitus and Arterial Hypertension.This work has been partially supported by Spanish Government Projects MINECO TIN2014-55637-C2-2-R and TIN2015-71618-R.Fernández-Olivares, J.; Onaindia De La Rivaherrera, E.; Castillo Vidal, L.; Jordán, J.; Cózar, J. (2019). Personalized conciliation of clinical guidelines for comorbid patients through multi-agent planning. Artificial Intelligence in Medicine. 96:167-186. https://doi.org/10.1016/j.artmed.2018.11.003S1671869

An ontological approach for pathology assessment and diagnosis of tunnels

Tunnel maintenance requires complex decision making, which involves pathology diagnosis and risk assessment, to ensure full safety while optimising maintenance and repair costs. A Decision Support System (DSS) can play a key role in this process by supporting the decision makers in identifying pathologies based on disorders present in various tunnel portions and contextual factors affecting a tunnel. Another key aspect is to identify which spatial stretches within a tunnel contain pathologies of similar kinds within neighbouring tunnel segments. This paper presents PADTUN, a novel intelligent decision support system that assists with pathology diagnosis and assessment of tunnels with respect to their disorders and diagnosis influencing factors. It utilises semantic web technologies for knowledge capture, representation, and reasoning. The core of PADTUN is a family of ontologies which represent the main concepts and relations associated with pathology assessment, and capture the decision process concerning tunnel maintenance. Tunnel inspection data is linked to these ontologies to take advantage of inference capabilities offered by semantic technologies. In addition, an intelligent mechanism is presented which exploits abstraction and inference capabilities. Thus PADTUN provides the world’s first semantically based intelligent DSS for tunnel maintenance. PADTUN was developed by an interdisciplinary team of tunnel experts and knowledge engineers in real-world settings offered by the NeTTUN EU Project. An evaluation of the PADTUN system is performed using real-world tunnel data and diagnosis tasks. We show how the use of semantic technologies allows addressing the complex issues of tunnel pathology inferencing, aiding in, and matching transportation experts’ expectations of decision support. The methodology is applicable to any linear transport structures, offering intelligent ways to aid with complex decision processes related to diagnosis and maintenance