Expertise and the interpretation of computerized physiological data: implications for the design of computerized monitoring in neonatal intensive care

This paper presents the outcomes from a cognitive engineering project addressing the design problems of computerized monitoring in neonatal intensive care. Cognitive engineering is viewed, in this project, as a symbiosis between cognitive science and design practice. A range of methodologies has been used: interviews with neonatal staff, ward observations and experimental techniques. The results of these investigations are reported, focusing specifically on the differences between junior and senior physicians in their interpretation of monitored physiological data. It was found that the senior doctors made better use of the different knowledge sources available than the junior doctors. The senior doctors were able to identify more relevant physiological patterns and generated more and better inferences than did their junior colleagues. Expertise differences are discussed in the context of previous psychological research in medical expertise. Finally, the paper discusses the potential utility of these outcomes to inform the design of computerized decision support in neonatal intensive care

User-centered visual analysis using a hybrid reasoning architecture for intensive care units

One problem pertaining to Intensive Care Unit information systems is that, in some cases, a very dense display of data can result. To ensure the overview and readability of the increasing volumes of data, some special features are required (e.g., data prioritization, clustering, and selection mechanisms) with the application of analytical methods (e.g., temporal data abstraction, principal component analysis, and detection of events). This paper addresses the problem of improving the integration of the visual and analytical methods applied to medical monitoring systems. We present a knowledge- and machine learning-based approach to support the knowledge discovery process with appropriate analytical and visual methods. Its potential benefit to the development of user interfaces for intelligent monitors that can assist with the detection and explanation of new, potentially threatening medical events. The proposed hybrid reasoning architecture provides an interactive graphical user interface to adjust the parameters of the analytical methods based on the users' task at hand. The action sequences performed on the graphical user interface by the user are consolidated in a dynamic knowledge base with specific hybrid reasoning that integrates symbolic and connectionist approaches. These sequences of expert knowledge acquisition can be very efficient for making easier knowledge emergence during a similar experience and positively impact the monitoring of critical situations. The provided graphical user interface incorporating a user-centered visual analysis is exploited to facilitate the natural and effective representation of clinical information for patient care

A comparative survey of integrated learning systems

This paper presents the duction framework for unifying the three basic forms of inference - deduction, abduction, and induction - by specifying the possible relationships and influences among them in the context of integrated learning. Special assumptive forms of inference are defined that extend the use of these inference methods, and the properties of these forms are explored. A comparison to a related inference-based learning frame work is made. Finally several existing integrated learning programs are examined in the perspective of the duction framework

Doctor of Philosophy

dissertationDisease-specific ontologies, designed to structure and represent the medical knowledge about disease etiology, diagnosis, treatment, and prognosis, are essential for many advanced applications, such as predictive modeling, cohort identification, and clinical decision support. However, manually building disease-specific ontologies is very labor-intensive, especially in the process of knowledge acquisition. On the other hand, medical knowledge has been documented in a variety of biomedical knowledge resources, such as textbook, clinical guidelines, research articles, and clinical data repositories, which offers a great opportunity for an automated knowledge acquisition. In this dissertation, we aim to facilitate the large-scale development of disease-specific ontologies through automated extraction of disease-specific vocabularies from existing biomedical knowledge resources. Three separate studies presented in this dissertation explored both manual and automated vocabulary extraction. The first study addresses the question of whether disease-specific reference vocabularies derived from manual concept acquisition can achieve a near-saturated coverage (or near the greatest possible amount of disease-pertinent concepts) by using a small number of literature sources. Using a general-purpose, manual acquisition approach we developed, this study concludes that a small number of expert-curated biomedical literature resources can prove sufficient for acquiring near-saturated disease-specific vocabularies. The second and third studies introduce automated techniques for extracting disease-specific vocabularies from both MEDLINE citations (title and abstract) and a clinical data repository. In the second study, we developed and assessed a pipeline-based system which extracts disease-specific treatments from PubMed citations. The system has achieved a mean precision of 0.8 for the top 100 extracted treatment concepts. In the third study, we applied classification models to reduce irrelevant disease-concepts associations extracted from MEDLINE citations and electronic medical records. This study suggested the combination of measures of relevance from disparate sources to improve the identification of true-relevant concepts through classification and also demonstrated the generalizability of the studied classification model to new diseases. With the studies, we concluded that existing biomedical knowledge resources are valuable sources for extracting disease-concept associations, from which classification based on statistical measures of relevance could assist a semi-automated generation of disease-specific vocabularies

An Ontology-Based Artificial Intelligence Model for Medicine Side-Effect Prediction: Taking Traditional Chinese Medicine as An Example

In this work, an ontology-based model for AI-assisted medicine side-effect (SE) prediction is developed, where three main components, including the drug model, the treatment model, and the AI-assisted prediction model, of proposed model are presented. To validate the proposed model, an ANN structure is established and trained by two hundred and forty-two TCM prescriptions. These data are gathered and classified from the most famous ancient TCM book and more than one thousand SE reports, in which two ontology-based attributions, hot and cold, are introduced to evaluate whether the prescription will cause SE or not. The results preliminarily reveal that it is a relationship between the ontology-based attributions and the corresponding predicted indicator that can be learnt by AI for predicting the SE, which suggests the proposed model has a potential in AI-assisted SE prediction. However, it should be noted that, the proposed model highly depends on the sufficient clinic data, and hereby, much deeper exploration is important for enhancing the accuracy of the prediction

Knowledge Based Systems: A Critical Survey of Major Concepts, Issues, and Techniques

This Working Paper Series entry presents a detailed survey of knowledge based systems. After being in a relatively dormant state for many years, only recently is Artificial Intelligence (AI) - that branch of computer science that attempts to have machines emulate intelligent behavior - accomplishing practical results. Most of these results can be attributed to the design and use of Knowledge-Based Systems, KBSs (or ecpert systems) - problem solving computer programs that can reach a level of performance comparable to that of a human expert in some specialized problem domain. These systems can act as a consultant for various requirements like medical diagnosis, military threat analysis, project risk assessment, etc. These systems possess knowledge to enable them to make intelligent desisions. They are, however, not meant to replace the human specialists in any particular domain. A critical survey of recent work in interactive KBSs is reported. A case study (MYCIN) of a KBS, a list of existing KBSs, and an introduction to the Japanese Fifth Generation Computer Project are provided as appendices. Finally, an extensive set of KBS-related references is provided at the end of the report

Characterizing environmental and phenotypic associations using information theory and electronic health records

The availability of up-to-date, executable, evidence-based medical knowledge is essential for many clinical applications, such as pharmacovigilance, but executable knowledge is costly to obtain and update. Automated acquisition of environmental and phenotypic associations in biomedical and clinical documents using text mining has showed some success. The usefulness of the association knowledge is limited, however, due to the fact that the specific relationships between clinical entities remain unknown. In particular, some associations are indirect relations due to interdependencies among the data. In this work, we develop methods using mutual information (MI) and its property, the data processing inequality (DPI), to help characterize associations that were generated based on use of natural language processing to encode clinical information in narrative patient records followed by statistical methods. Evaluation based on a random sample consisting of two drugs and two diseases indicates an overall precision of 81%. This preliminary study demonstrates that the proposed method is effective for helping to characterize phenotypic and environmental associations obtained from clinical reports