A Generic Approach to Supporting the Management of Computerised Clinical Guidelines and Protocols

Clinical guidelines or protocols (CGPs) are statements that are systematically developed for the purpose of guiding the clinician and the patient in making decisions about appropriate healthcare for specific clinical problems. Using CGPs is one of the most effective and proven ways to attaining improved quality, optimised resource utilisation, cost containment and reduced variation in healthcare practice. CGPs exist mainly as paper-based natural language statements, but are increasingly being computerised. Supporting computerised CGPs in a healthcare environment so that they are incorporated into the routine used daily by clinicians is complex and presents major information management challenges. This thesis contends that the management of computerised CGPs should incorporate their manipulation (operations and queries), in addition to their specification and execution, as part of a single unified management framework. The thesis applies modern advanced database technology to the task of managing computerised CGPs. The event-condition-action (ECA) rule paradigm is recognised to have a huge potential in supporting computerised CGPs. In this thesis, a unified generic framework, called SpEM and an approach, called MonCooS, were developed for enabling computerised CGPs, to be specified by using a specification language, called PLAN, which follows the ECA rule paradigm; executed by using a software mechanism based on the ECA mechanism within a modern database system, and manipulated by using a manipulation language, called TOPSQL. The MonCooS approach focuses on providing clinicians with assistance in monitoring and coordinating clinical interventions while leaving the reasoning task to domain experts. A proof-of-concepts system, TOPS, was developed to show that CGP management can be easily attained, within the SpEM framework, by using the MonCooS approach. TOPS is used to evaluate the framework and approach in a case study to manage a microalbuminuria protocol for diabetic patients. SpEM and MonCooS were found to be promising in supporting the full-scale management of information and knowledge for the computerised clinical protocol. Active capability within modern DBMS is still experiencing significant limitations in supporting some requirements of this application domain. These limitations lead to pointers for further improvements in database management system (DBMS) functionality for ECA rule support. The main contributions of this thesis are: a generic and unified framework for the management of CGPs; a general platform and an advanced software mechanism for the manipulation of information and knowledge in computerised CGPs; a requirement for further development of the active functionality within modern DBMS; and a case study for the computer-based management of microalbuminuria in diabetes patients

METADATA MANAGEMENT FOR CLINICAL DATA INTEGRATION

Clinical data have been continuously collected and growing with the wide adoption of electronic health records (EHR). Clinical data have provided the foundation to facilitate state-of-art researches such as artificial intelligence in medicine. At the same time, it has become a challenge to integrate, access, and explore study-level patient data from large volumes of data from heterogeneous databases. Effective, fine-grained, cross-cohort data exploration, and semantically enabled approaches and systems are needed. To build semantically enabled systems, we need to leverage existing terminology systems and ontologies. Numerous ontologies have been developed recently and they play an important role in semantically enabled applications. Because they contain valuable codified knowledge, the management of these ontologies, as metadata, also requires systematic approaches. Moreover, in most clinical settings, patient data are collected with the help of a data dictionary. Knowledge of the relationships between an ontology and a related data dictionary is important for semantic interoperability. Such relationships are represented and maintained by mappings. Mappings store how data source elements and domain ontology concepts are linked, as well as how domain ontology concepts are linked between different ontologies. While mappings are crucial to the maintenance of relationships between an ontology and a related data dictionary, they are commonly captured by CSV files with limits capabilities for sharing, tracking, and visualization. The management of mappings requires an innovative, interactive, and collaborative approach. Metadata management servers to organize data that describes other data. In computer science and information science, ontology is the metadata consisting of the representation, naming, and definition of the hierarchies, properties, and relations between concepts. A structural, scalable, and computer understandable way for metadata management is critical to developing systems with the fine-grained data exploration capabilities. This dissertation presents a systematic approach called MetaSphere using metadata and ontologies to support the management and integration of clinical research data through our ontology-based metadata management system for multiple domains. MetaSphere is a general framework that aims to manage specific domain metadata, provide fine-grained data exploration interface, and store patient data in data warehouses. Moreover, MetaSphere provides a dedicated mapping interface called Interactive Mapping Interface (IMI) to map the data dictionary to well-recognized and standardized ontologies. MetaSphere has been applied to three domains successfully, sleep domain (X-search), pressure ulcer injuries and deep tissue pressure (SCIPUDSphere), and cancer. Specifically, MetaSphere stores domain ontology structurally in databases. Patient data in the corresponding domains are also stored in databases as data warehouses. MetaSphere provides a powerful query interface to enable interaction between human and actual patient data. Query interface is a mechanism allowing researchers to compose complex queries to pinpoint specific cohort over a large amount of patient data. The MetaSphere framework has been instantiated into three domains successfully and the detailed results are as below. X-search is publicly available at https://www.x-search.net with nine sleep domain datasets consisting of over 26,000 unique subjects. The canonical data dictionary contains over 900 common data elements across the datasets. X-search has received over 1800 cross-cohort queries by users from 16 countries. SCIPUDSphere has integrated a total number of 268,562 records containing 282 ICD9 codes related to pressure ulcer injuries among 36,626 individuals with spinal cord injuries. IMI is publicly available at http://epi-tome.com/. Using IMI, we have successfully mapped the North American Association of Central Cancer Registries (NAACCR) data dictionary to the National Cancer Institute Thesaurus (NCIt) concepts

A Model-Driven Architecture based Evolution Method and Its Application in An Electronic Learning System

Software products have been racing against aging problem for most of their lifecycles, and evolution is the most effective and efficient solution to this problem. Model-Driven Architecture (MDA) is a new technique for software product for evolving development and reengineering methods. The main steps for MDA are to establish models in different levels and phases, therefore to solve the challenges of requirement and technology change. However, there is only a standard established by Object Management Group (OMG) but without a formal method and approach. Presently, MDA is widely researched in both industrial and research areas, however, there is still without a smooth approach to realise it especially in electronic learning (e-learning) system due to the following reasons: (1) models’ transformations are hard to realise because of lack of tools, (2) most of existing mature research results are working for business and government services but not education area, and (3) most of existing model-driven researches are based on Model-Driven Development (MDD) but not MDA because of OMG standard’s preciseness. Hence, it is worth to investigate an MDA-based method and approach to improve the existing software development approach for e-learning system. Due to the features of MDA actuality, a MDA-based evolution method and approach is proposed in this thesis. The fundamental theories of this research are OMG’s MDA standard and education pedagogical knowledge. Unified Modelling Language (UML) and Unified Modelling Language Profile are hired to represent the information of software system from different aspects. This study can be divided into three main parts: MDA-based evolution method and approach research, Platform-Independent Model (PIM) to Platform-Specific Model (PSM) transformation development, and MDA-based electronic learning system evolution. Top-down approach is explored to develop models for e-learning system. A transformation approach is developed to generate Computation Independent Model (CIM), Platform-Independent Model (PIM), and Platform-Specific Model (PSM); while a set of transformation rules are defined following MDA standard to support PSM’ s generation. In addition, proposed method is applied in an e-learning system as a case study with the prototype rules support. In the end, conclusions are drawn based on analysis and further research directions are discussed as well. The kernel contributions are the proposed transformation rules and its application in electronic learning system

Big Data Now, 2015 Edition

Now in its fifth year, O’Reilly’s annual Big Data Now report recaps the trends, tools, applications, and forecasts we’ve talked about over the past year. For 2015, we’ve included a collection of blog posts, authored by leading thinkers and experts in the field, that reflect a unique set of themes we’ve identified as gaining significant attention and traction. Our list of 2015 topics include: Data-driven cultures Data science Data pipelines Big data architecture and infrastructure The Internet of Things and real time Applications of big data Security, ethics, and governance Is your organization on the right track? Get a hold of this free report now and stay in tune with the latest significant developments in big data

Engineering Agile Big-Data Systems

To be effective, data-intensive systems require extensive ongoing customisation to reflect changing user requirements, organisational policies, and the structure and interpretation of the data they hold. Manual customisation is expensive, time-consuming, and error-prone. In large complex systems, the value of the data can be such that exhaustive testing is necessary before any new feature can be added to the existing design. In most cases, the precise details of requirements, policies and data will change during the lifetime of the system, forcing a choice between expensive modification and continued operation with an inefficient design.Engineering Agile Big-Data Systems outlines an approach to dealing with these problems in software and data engineering, describing a methodology for aligning these processes throughout product lifecycles. It discusses tools which can be used to achieve these goals, and, in a number of case studies, shows how the tools and methodology have been used to improve a variety of academic and business systems

Implementation of Middleware for Internet of Things in Asset Tracking Applications: In-lining Approach

ThesisInternet of Things (IoT) is a concept that involves giving objects a digital identity and limited artificial intelligence, which helps the objects to be interactive, process data, make decisions, communicate and react to events virtually with minimum human intervention. IoT is intensified by advancements in hardware and software engineering and promises to close the gap that exists between the physical and digital worlds. IoT is paving ways to address complex phenomena, through designing and implementation of intelligent systems that can monitor phenomena, perform real-time data interpretation, react to events, and swiftly communicate observations. The primary goal of IoT is ubiquitous computing using wireless sensors and communication protocols such as Bluetooth, Wireless Fidelity (Wi-Fi), ZigBee and General Packet Radio Service (GPRS). Insecurity, of assets and lives, is a problem around the world. One application area of IoT is tracking and monitoring; it could therefore be used to solve asset insecurity. A preliminary investigation revealed that security systems in place at Central University of Technology, Free State (CUT) are disjointed; they do not instantaneously and intelligently conscientize security personnel about security breaches using real time messages. As a result, many assets have been stolen, particularly laptops. The main objective of this research was to prove that a real-life application built over a generic IoT architecture that innovatively and intelligently integrates: (1) wireless sensors; (2) radio frequency identification (RFID) tags and readers; (3) fingerprint readers; and (4) mobile phones, can be used to dispel laptop theft. To achieve this, the researcher developed a system, using the heterogeneous devices mentioned above and a middleware that harnessed their unique capabilities to bring out the full potential of IoT in intelligently curbing laptop theft. The resulting system has the ability to: (1) monitor the presence of a laptop using RFID reader that pro-actively interrogates a passive tag attached to the laptop; (2) detect unauthorized removal of a laptop under monitoring; (3) instantly communicate security violations via cell phones; and (4) use Windows location sensors to track the position of a laptop using Googlemaps. The system also manages administrative tasks such as laptop registration, assignment and withdrawal which used to be handled manually. Experiments conducted using the resulting system prototype proved the hypothesis outlined for this research