Gold standard evaluation of an automatic HAIs surveillance system

Hospital-acquired Infections (HAIs) surveillance, defined as the systematic collection of data related to a certain health event, is considered an essential dimension for a prevention HAI program to be effective. In recent years, new automated HAI surveillance methods have emerged with the wide adoption of electronic health records (EHR). Here we present the validation results against the gold standard of HAIs diagnosis of the InNoCBR system deployed in the Ourense University Hospital Complex (Spain). Acting as a totally autonomous system, InNoCBR achieves a HAI sensitivity of 70.83% and a specificity of 97.76%, with a positive predictive value of 77.24%. The kappa index for infection type classification is 0.67. Sensitivity varies depending on infection type, where bloodstream infection attains the best value (93.33%), whereas the respiratory infection could be improved the most (53.33%). Working as a semi-automatic system, InNoCBR reaches a high level of sensitivity (81.73%), specificity (99.47%), and a meritorious positive predictive value (94.33%).Xunta de Galicia | Ref. ED431C2018/55-GR

Artificial intelligence-based tools to control healthcare associated infections: A systematic review of the literature

Background: Healthcare-associated infections (HAIs) are the most frequent adverse events in healthcare and a global public health concern. Surveillance is the foundation for effective HAIs prevention and control. Manual surveillance is labor intensive, costly and lacks standardization. Artificial Intelligence (AI) and machine learning (ML) might support the development of HAI surveillance algorithms aimed at understanding HAIs risk factors, improve patient risk stratification, identification of transmission pathways, timely or real-time detection. Scant evidence is available on AI and ML implementation in the field of HAIs and no clear patterns emerges on its impact. Methods: We conducted a systematic review following the PRISMA guidelines to systematically retrieve, quantitatively pool and critically appraise the available evidence on the development, implementation, performance and impact of ML-based HAIs detection models. Results: Of 3445 identified citations, 27 studies were included in the review, the majority published in the US (n = 15, 55.6%) and on surgical site infections (SSI, n = 8, 29.6%). Only 1 randomized controlled trial was included. Within included studies, 17 (63%) ML approaches were classified as predictive and 10 (37%) as retrospective. Most of the studies compared ML algorithms' performance with non-ML logistic regression statistical algorithms, 18.5% compared different ML models' performance, 11.1% assessed ML algorithms' performance in comparison with clinical diagnosis scores, 11.1% with standard or automated surveillance models. Overall, there is moderate evidence that ML-based models perform equal or better as compared to non-ML approaches and that they reach relatively high-performance standards. However, heterogeneity amongst the studies is very high and did not dissipate significantly in subgroup analyses, by type of infection or type of outcome. Discussion: Available evidence mainly focuses on the development and testing of HAIs detection and prediction models, while their adoption and impact for research, healthcare quality improvement, or national surveillance purposes is still far from being explored

Innovative Business Model for Smart Healthcare Insurance

Information revolution and technology growth have made a considerable contribution to restraining the cost expansion and empowering the customer. They disrupted most business models in different industries. The customer-centric business model has pervaded the different sectors. Smart healthcare has made an enormous shift in patient life and raised their expectations of healthcare services quality. Healthcare insurance is an essential business in the healthcare sector; patients expect a new business model to meet their needs and enhance their wellness. This research develops a holistic smart healthcare architecture based on the recent development of information and communications technology. Then develops a disruptive healthcare insurance business model that adapts to this architecture and classifies the patient according to their technology needs. Finally, and implementing a prototype of a system that matches and suits the healthcare recipient condition to the proper healthcare insurance policy by applying Web Ontology Language (OWL) and rule-based reasoning model using SWRL using Protég

A framework for decision making on teleexpertise with traceability of the reasoning

This paper provides a methodological framework for decision making process to ensure its traceability generally in the context of telemedicine and particularly in the act of teleexpertise. This act permits to medical professionals and/or health professionals to collaborate in order to take suitable decisions for a patient diagnosis or treatment. The main problem dealing with teleexpertise is the following: How to ensure the traceability of the decisions making process? This problem is solved in this paper through a conceptualisation of a rigorous framework coupling semantic modelling and explicit reasoning which permits to fully support the analysis and rationale for decisions made. The logical semantic underlying this framework is the argumentative logicto provide adequate management of information with traceability of the reasoning including options and constraints. Thus our proposal will permit to formally ensure the traceability of reasoning in telemedicine and particularly in teleexpertise in order to favour the quality of telemedicine’s procedure checking. This traceability is to guarantee equitable access to the benefits of the collective knowledge and experience and to provide remote collaborative practices with a sufficient safety margin to guard against the legal requirements. An illustrative case study is provided by the modelling of a decision making process applied to teleexpertise for chronic diseases such as diabetes mellitus type2

Conceptual modelling of explanation experiences through the iSeeonto ontology.

Explainable Artificial Intelligence is a big research field required in many situations where we need to understand Artificial Intelligence behaviour. However, each explanation need is unique which makes it difficult to apply explanation techniques and solutions that are already implemented when faced with a new problem. Therefore, the task to implement an explanation system can be very challenging because we need to take the AI model into account, user's needs and goals, available data, suitable explainers, etc. In this work, we propose a formal model to define and orchestrate all the elements involved in an explanation system, and make a novel contribution regarding the formalisation of this model as the iSeeOnto ontology. This ontology not only enables the conceptualisation of a wide range of explanation systems, but also supports the application of Case-Based Reasoning as a knowledge transfer approach that reuses previous explanation experiences from unrelated domains. To demonstrate the suitability of the proposed model, we present an exhaustive validation by classifying reference explanation systems found in the literature into the iSeeOnto ontology

How Fair Is IS Research?

While both information systems and machine learning are not neutral, the identification of discrimination is more difficult if a system learns from data and discrimination can be introduced at several stages. Therefore, this article investigates if IS Research has taken up with this topic. A literature analysis is conducted and its discussion shows that technology, organization, and human aspects have to be considered, making it a topic not only for data scientist or computer scientist, but for information systems researchers as well

Proposition d'un modèle organisationnel de prévention des risques d'infections associées aux soins

International audienceAlors que les infections associées aux soins (IAS) continuent à provoquer de nombreux décès en France et partout dans le monde, il est désormais essentiel d'évaluer l'efficacité des diverses stratégies de prévention mises en place. Nous proposons dans cet article, pour répondre aux appels de Zingg et al. (2015) et de Jacob et al. (2018), une nouvelle façon d'évaluer ces stratégies en intégrant dans la réflexion, le contexte organisationnel et le contexte clinique (état et parcours de soins du patient) dans lesquels elles sont mises en place. Cette nouvelle approche configurationnelle de la prévention des risques infectieux consiste à chercher des configurations cohérentes entre des types de stratégies de prévention, des contextes organisationnels et des contextes cliniques qui mènent à un risque infectieux plus faible. Elle repose donc sur un modèle organisationnel de prévention des risques infectieux qui dépasse l'approche classique en « silo » de la gestion des risques où chacun évalue le risque de sa propre action, pour aller vers une approche qui met l'accent sur la coordination des soins ou « care management » et les facteurs qui la favorisent : culture organisationnelle, existence de champions de bonnes pratiques, empowerment des patients et du personnel… Cette approche configurationnelle d'un modèle organisationnel de prévention des risques infectieux est appliquée dans le cadre d'un projet de l'Institut PRESAGE de Prévention et de Santé Globale, qui réunit des chercheurs de différentes disciplines (juristes, économistes, gestionnaires, psychologues…) et des praticiens de différents horizons (médecins, infirmières, cadres de santé) afin d'explorer de nouvelles solutions pour réduire le risque infectieux, ces solutions pouvant relever notamment de l'organisation et de la coordination des soins