Platform for efficient switching between multiple devices in the intensive care unit

Introduction: This article is part of the Focus Theme of Methods of Information in Medicine on "Managing Interoperability and Complexity in Health Systems". Objectives: Handheld computers, such as tablets and smartphones, are becoming more and more accessible in the clinical care setting and in Intensive Care Units (ICUs). By making the most useful and appropriate data available on multiple devices and facilitate the switching between those devices, staff members can efficiently integrate them in their workflow, allowing for faster and more accurate decisions. This paper addresses the design of a platform for the efficient switching between multiple devices in the ICU. The key functionalities of the platform are the integration of the platform into the workflow of the medical staff and providing tailored and dynamic information at the point of care. Methods: The platform is designed based on a 3-tier architecture with a focus on extensibility, scalability and an optimal user experience. After identification to a device using Near Field Communication (NFC), the appropriate medical information will be shown on the selected device. The visualization of the data is adapted to the type of the device. A web-centric approach was used to enable extensibility and portability. Results: A prototype of the platform was thoroughly evaluated. The scalability, performance and user experience were evaluated. Performance tests show that the response time of the system scales linearly with the amount of data. Measurements with up to 20 devices have shown no performance loss due to the concurrent use of multiple devices. Conclusions: The platform provides a scalable and responsive solution to enable the efficient switching between multiple devices., Due to the web-centric approach new devices can easily be integrated. The performance and scalability of the platform have been evaluated and it was shown that the response time and scalability of the platform was within an acceptable range

Big data analytics in intensive care units: challenges and applicability in an Argentinian hospital

In a typical intensive care unit of a healthcare facilities, many sensors are connected to patients to measure high frequency physiological data. Currently, measurements are registered from time to time, possibly every hour. With this data lost, we are losing many opportunities to discover new patterns in vital signs that could lead to earlier detection of pathologies. The early detection of pathologies gives physicians the ability to plan and begin treatments sooner or potentially stop the progression of a condition, possibly reducing mortality and costs. The data generated by medical equipment are a Big Data problem with near real-time restrictions for processing medical algorithms designed to predict pathologies. This type of system is known as realtime big data analytics systems. This paper analyses if proposed system architectures can be applied in the Francisco Lopez Lima Hospital (FLLH), an Argentinian hospital with relatively high financial constraints. Taking into account this limitation, we describe a possible architectural approach for the FLLH, a mix of a local computing system at FLLH and a public cloud computing platform. We believe this work may be useful to promote the research and development of such systems in intensive care units of hospitals with similar characteristics to the FLLH.Facultad de Informátic

Big data analytics in intensive care units: challenges and applicability in an Argentinian hospital

In a typical intensive care unit of a healthcare facilities, many sensors are connected to patients to measure high frequency physiological data. Currently, measurements are registered from time to time, possibly every hour. With this data lost, we are losing many opportunities to discover new patterns in vital signs that could lead to earlier detection of pathologies. The early detection of pathologies gives physicians the ability to plan and begin treatments sooner or potentially stop the progression of a condition, possibly reducing mortality and costs. The data generated by medical equipment are a Big Data problem with near real-time restrictions for processing medical algorithms designed to predict pathologies. This type of system is known as realtime big data analytics systems. This paper analyses if proposed system architectures can be applied in the Francisco Lopez Lima Hospital (FLLH), an Argentinian hospital with relatively high financial constraints. Taking into account this limitation, we describe a possible architectural approach for the FLLH, a mix of a local computing system at FLLH and a public cloud computing platform. We believe this work may be useful to promote the research and development of such systems in intensive care units of hospitals with similar characteristics to the FLLH.Facultad de Informátic

Infectious Disease Ontology

Technological developments have resulted in tremendous increases in the volume and diversity of the data and information that must be processed in the course of biomedical and clinical research and practice. Researchers are at the same time under ever greater pressure to share data and to take steps to ensure that data resources are interoperable. The use of ontologies to annotate data has proven successful in supporting these goals and in providing new possibilities for the automated processing of data and information. In this chapter, we describe different types of vocabulary resources and emphasize those features of formal ontologies that make them most useful for computational applications. We describe current uses of ontologies and discuss future goals for ontology-based computing, focusing on its use in the field of infectious diseases. We review the largest and most widely used vocabulary resources relevant to the study of infectious diseases and conclude with a description of the Infectious Disease Ontology (IDO) suite of interoperable ontology modules that together cover the entire infectious disease domain

Distributed Knowledge Modeling and Integration of Model-Based Beliefs into the Clinical Decision-Making Process

Das Treffen komplexer medizinischer Entscheidungen wird durch die stetig steigende Menge an zu berücksichtigenden Informationen zunehmend komplexer. Dieser Umstand ist vor allem auf die Verfügbarkeit von immer präziseren diagnostischen Methoden zur Charakterisierung der Patienten zurückzuführen (z.B. genetische oder molekulare Faktoren). Hiermit einher geht die Entwicklung neuartiger Behandlungsstrategien und Wirkstoffe sowie die damit verbundenen Evidenzen aus klinischen Studien und Leitlinien. Dieser Umstand stellt die behandelnden Ärztinnen und Ärzte vor neuartige Herausforderungen im Hinblick auf die Berücksichtigung aller relevanten Faktoren im Kontext der klinischen Entscheidungsfindung. Moderne IT-Systeme können einen wesentlichen Beitrag leisten, um die klinischen Experten weitreichend zu unterstützen. Diese Assistenz reicht dabei von Anwendungen zur Vorverarbeitung von Daten für eine Reduktion der damit verbundenen Komplexität bis hin zur systemgestützten Evaluation aller notwendigen Patientendaten für eine therapeutischen Entscheidungsunterstützung. Möglich werden diese Funktionen durch die formale Abbildung von medizinischem Fachwissen in Form einer komplexen Wissensbasis, welche die kognitiven Prozesse im Entscheidungsprozess adaptiert. Entsprechend werden an den Prozess der IT-konformen Wissensabbildung erhöhte Anforderungen bezüglich der Validität und Signifikanz der enthaltenen Informationen gestellt. In den ersten beiden Kapiteln dieser Arbeit wurden zunächst wichtige methodische Grundlagen im Kontext der strukturierten Abbildung von Wissen sowie dessen Nutzung für die klinische Entscheidungsunterstützung erläutert. Hierbei wurden die inhaltlichen Kernthemen weiterhin im Rahmen eines State of the Art mit bestehenden Ansätzen abgeglichen, um den neuartigen Charakter der vorgestellten Lösungen herauszustellen. Als innovativer Kern wurde zunächst die Konzeption und Umsetzung eines neuartigen Ansatzes zur Fusion von fragmentierten Wissensbausteinen auf der formalen Grundlage von Bayes-Netzen vorgestellt. Hierfür wurde eine neuartige Datenstruktur unter Verwendung des JSON Graph Formats erarbeitet. Durch die Entwicklung von qualifizierten Methoden zum Umgang mit den formalen Kriterien eines Bayes-Netz wurden weiterhin Lösungen aufgezeigt, welche einen automatischen Fusionsprozess durch einen eigens hierfür entwickelten Algorithmus ermöglichen. Eine prototypische und funktionale Plattform zur strukturierten und assistierten Integration von Wissen sowie zur Erzeugung valider Bayes-Netze als Resultat der Fusion wurde unter Verwendung eines Blockchain Datenspeichers implementiert und in einer Nutzerstudie gemäß ISONORM 9241/110-S evaluiert. Aufbauend auf dieser technologischen Plattform wurden im Anschluss zwei eigenständige Entscheidungsunterstützungssysteme vorgestellt, welche relevante Anwendungsfälle im Kontext der HNO-Onkologie adressieren. Dies ist zum einen ein System zur personalisierten Bewertung von klinischen Laborwerten im Kontext einer Radiochemotherapie und zum anderen ein in Form eines Dashboard implementiertes Systems zur effektiveren Informationskommunikation innerhalb des Tumor Board. Beide Konzepte wurden hierbei zunächst im Rahmen einer initialen Nutzerstudie auf Relevanz geprüft, um eine nutzerzentrische Umsetzung zu gewährleisten. Aufgrund des zentralen Fokus dieser Arbeit auf den Bereich der klinischen Entscheidungsunterstützung, werden an zahlreichen Stellen sowohl kritische als auch optimistische Aspekte der damit verbundenen praktischen Lösungen diskutiert.:1 Introduction 1.1 Motivation and Clinical Setting 1.2 Objectives 1.3 Thesis Outline 2 State of the Art 2.1 Medical Knowledge Modeling 2.2 Knowledge Fusion 2.3 Clinical Decision Support Systems 2.4 Clinical Information Access 3 Fundamentals 3.1 Evidence-Based Medicine 3.1.1 Literature-Based Evidence 3.1.2 Practice-Based Evidence 3.1.3 Patient-Directed Evidence 3.2 Knowledge Representation Formats 3.2.1 Logic-Based Representation 3.2.2 Procedural Representation 3.2.3 Network or Graph-Based Representation 3.3 Knowledge-Based Clinical Decision Support 3.4 Conditional Probability and Bayesian Networks 3.5 Clinical Reasoning 3.5.1 Deterministic Reasoning 3.5.2 Probabilistic Reasoning 3.6 Knowledge Fusion of Bayesian Networks 4 Block-Based Collaborative Knowledge Modeling 4.1 Data Model 4.1.1 Belief Structure 4.1.2 Conditional Probabilities 4.1.3 Metadata 4.2 Constraint-Based Automatic Knowledge Fusion 4.2.1 Fusion of the Bayesian Network Structures 4.2.2 Fusion of the Conditional Probability Tables 4.3 Blockchain-Based Belief Storage and Retrieval 4.3.1 Blockchain Characteristics 4.3.2 Relevance for Belief Management 5 Selected CDS Applications for Clinical Practice 5.1 Distributed Knowledge Modeling Platform 5.1.1 Requirement Analysis 5.1.2 System Architecture 5.1.3 System Evaluation 5.1.4 Limitations of the Proposed Solution 5.2 Personalization of Laboratory Findings 5.2.1 Requirement Analysis 5.2.2 System Architecture 5.2.3 Limitations of the Proposed Solution 5.3 Dashboard for Collaborative Decision-Making in the Tumor Board 5.3.1 Requirement Analysis 5.3.2 System Architecture 5.3.3 Limitations of the Proposed Solution 6 Discussion 6.1 Goal Achievements 6.2 Contributions and Conclusion 7 Bibliograph

Efficient Decision Support Systems

This series is directed to diverse managerial professionals who are leading the transformation of individual domains by using expert information and domain knowledge to drive decision support systems (DSSs). The series offers a broad range of subjects addressed in specific areas such as health care, business management, banking, agriculture, environmental improvement, natural resource and spatial management, aviation administration, and hybrid applications of information technology aimed to interdisciplinary issues. This book series is composed of three volumes: Volume 1 consists of general concepts and methodology of DSSs; Volume 2 consists of applications of DSSs in the biomedical domain; Volume 3 consists of hybrid applications of DSSs in multidisciplinary domains. The book is shaped decision support strategies in the new infrastructure that assists the readers in full use of the creative technology to manipulate input data and to transform information into useful decisions for decision makers

A Systematic Review of Knowledge Visualization Approaches Using Big Data Methodology for Clinical Decision Support

This chapter reports on results from a systematic review of peer-reviewed studies related to big data knowledge visualization for clinical decision support (CDS). The aims were to identify and synthesize sources of big data in knowledge visualization, identify visualization interactivity approaches for CDS, and summarize outcomes. Searches were conducted via PubMed, Embase, Ebscohost, CINAHL, Medline, Web of Science, and IEEE Xplore in April 2019, using search terms representing concepts of: big data, knowledge visualization, and clinical decision support. A Google Scholar gray literature search was also conducted. All references were screened for eligibility. Our review returned 3252 references, with 17 studies remaining after screening. Data were extracted and coded from these studies and analyzed using a PICOS framework. The most common audience intended for the studies was healthcare providers (n = 16); the most common source of big data was electronic health records (EHRs) (n = 12), followed by microbiology/pathology laboratory data (n = 8). The most common intervention type was some form of analysis platform/tool (n = 7). We identified and classified studies by visualization type, user intent, big data platforms and tools used, big data analytics methods, and outcomes from big data knowledge visualization of CDS applications

Contribution to the Association Rules Visualization for Decision Support: A Combined Use Between Boolean Modeling and the Colored 2D Matrix

In the present paper we aim to study the visual decision support based on Cellular machine CASI (Cellular Automata for Symbolic Induction). The purpose is to improve the visualization of large sets of association rules, in order to perform Clinical decision support system and decrease doctors’ cognitive charge. One of the major problems in processing association rules is the exponential growth of generated rules volume which impacts doctor’s adaptation. In order to clarify it, many approaches meant to represent this set of association rules under visual context have been suggested. In this article we suggest to use jointly the CASI cellular machine and the colored 2D matrices to improve the visualization of association rules. Our approach has been divided into four important phases: (1) Data preparation, (2) Extracting association rules, (3) Boolean modeling of the rules base (4) 2D visualization colored by Boolean inferences