Argumentation with goals for clinical decision support in multimorbidity

The present work proposes a computational argumentation system equipped with goal seeking to combine independently generated recommendations for handling multimorbidity.- (undefined

Goal-Driven Structured Argumentation for Patient Management in a Multimorbidity Setting

We use computational argumentation to both analyse and generate solutions for reasoning in multimorbidity about consistent recommendations, according to different patient-centric goals. Reasoning in this setting carries a complexity related to the multiple variables involved. These variables reflect the co-existing health conditions that should be considered when defining a proper therapy. However, current Clinical Decision Support Systems (CDSSs) are not equipped to deal with such a situation. They do not go beyond the straightforward application of the rules that build their knowledge base and simple interpretation of Computer-Interpretable Guidelines (CIGs). We provide a computational argumentation system equipped with goal-seeking mechanisms to combine independently generated recommendations, with the ability to resolve conflicts and generate explanations for its results. We also discuss its advantages over and relation to Multiple-criteria Decision-making (MCDM) in this particular setting.- (undefined

Resolving conflicts in clinical guidelines using argumentation

Automatically reasoning with conflicting generic clinical guidelines is a burning issue in patient-centric medical reasoning where patient-specific conditions and goals need to be taken into account. It is even more challenging in the presence of preferences such as patient's wishes and clinician's priorities over goals. We advance a structured argumentation formalism for reasoning with conflicting clinical guidelines, patient-specific information and preferences. Our formalism integrates assumption-based reasoning and goal-driven selection among reasoning outcomes. Specifically, we assume applicability of guideline recommendations concerning the generic goal of patient well-being, resolve conflicts among recommendations using patient's conditions and preferences, and then consider prioritised patient-centered goals to yield non-conflicting, goal-maximising and preference-respecting recommendations. We rely on the state-of-the-art Transition-based Medical Recommendation model for representing guideline recommendations and augment it with context given by the patient's conditions, goals, as well as preferences over recommendations and goals. We establish desirable properties of our approach in terms of sensitivity to recommendation conflicts and patient context

ROAD2H: Development and evaluation of an open-source explainable artificial intelligence approach for managing co-morbidity and clinical guidelines.

INTRODUCTION: Clinical decision support (CDS) systems (CDSSs) that integrate clinical guidelines need to reflect real-world co-morbidity. In patient-specific clinical contexts, transparent recommendations that allow for contraindications and other conflicts arising from co-morbidity are a requirement. In this work, we develop and evaluate a non-proprietary, standards-based approach to the deployment of computable guidelines with explainable argumentation, integrated with a commercial electronic health record (EHR) system in Serbia, a middle-income country in West Balkans. METHODS: We used an ontological framework, the Transition-based Medical Recommendation (TMR) model, to represent, and reason about, guideline concepts, and chose the 2017 International global initiative for chronic obstructive lung disease (GOLD) guideline and a Serbian hospital as the deployment and evaluation site, respectively. To mitigate potential guideline conflicts, we used a TMR-based implementation of the Assumptions-Based Argumentation framework extended with preferences and Goals (ABA+G). Remote EHR integration of computable guidelines was via a microservice architecture based on HL7 FHIR and CDS Hooks. A prototype integration was developed to manage chronic obstructive pulmonary disease (COPD) with comorbid cardiovascular or chronic kidney diseases, and a mixed-methods evaluation was conducted with 20 simulated cases and five pulmonologists. RESULTS: Pulmonologists agreed 97% of the time with the GOLD-based COPD symptom severity assessment assigned to each patient by the CDSS, and 98% of the time with one of the proposed COPD care plans. Comments were favourable on the principles of explainable argumentation; inclusion of additional co-morbidities was suggested in the future along with customisation of the level of explanation with expertise. CONCLUSION: An ontological model provided a flexible means of providing argumentation and explainable artificial intelligence for a long-term condition. Extension to other guidelines and multiple co-morbidities is needed to test the approach further

EQRbot: A chatbot delivering EQR argument-based explanations

Data availability statement: The provided link: https://github.com/FCast07/EQRbot refers to the GitHub repository that stores the chatbot programming code.Recent years have witnessed the rise of several new argumentation-based support systems, especially in the healthcare industry. In the medical sector, it is imperative that the exchange of information occurs in a clear and accurate way, and this has to be reflected in any employed virtual systems. Argument Schemes and their critical questions represent well-suited formal tools for modeling such information and exchanges since they provide detailed templates for explanations to be delivered. This paper details the EQR argument scheme and deploys it to generate explanations for patients' treatment advice using a chatbot (EQRbot). The EQR scheme (devised as a pattern of Explanation-Question-Response interactions between agents) comprises multiple premises that can be interrogated to disclose additional data. The resulting explanations, obtained as instances of the employed argumentation reasoning engine and the EQR template, will then feed the conversational agent that will exhaustively convey the requested information and answers to follow-on users' queries as personalized Telegram messages. Comparisons with a previous baseline and existing argumentation-based chatbots illustrate the improvements yielded by EQRbot against similar conversational agents.This research was partially funded by the UK Engineering & Physical Sciences Research Council (EPSRC) under Grant #EP/P010105/1

A literature review. Introduction to the special issue

UIDB/00183/2020 UIDP/00183/2020 PTDC/FER-FIL/28278/2017 CHIST-ERA/0002/2019Argumentation schemes [35, 80, 91] are a relatively recent notion that continues an extremely ancient debate on one of the foundations of human reasoning, human comprehension, and obviously human argumentation, i.e., the topics. To understand the revolutionary nature of Walton’s work on this subject matter, it is necessary to place it in the debate that it continues and contributes to, namely a view of logic that is much broader than the formalistic perspective that has been adopted from the 20th century until nowadays. With his book Argumentation schemes for presumptive reasoning, Walton attempted to start a dialogue between three different fields or views on human reasoning – one (argumentation theory) very recent, one (dialectics) very ancient and with a very long tradition, and one (formal logic) relatively recent, but dominating in philosophy. Argumentation schemes were proposed as dialectical instruments, in the sense that they represented arguments not only as formal relations, but also as pragmatic inferences, as they at the same time depend on what the interlocutors share and accept in a given dialogical circumstance, and affect their dialogical relation. In this introduction, the notion of argumentation scheme will be analyzed in detail, showing its different dimensions and its defining features which make them an extremely useful instrument in Artificial Intelligence. This theoretical background will be followed by a literature review on the uses of the schemes in computing, aimed at identifying the most important areas and trends, the most promising proposals, and the directions of future research.publishersversionpublishe

Self-management of complex chronic conditions: Recommendations for qualitative health communication research

Background: Chronic conditions are on the rise worldwide, urging researchers to increase efforts to develop tailored self-management interventions. Theories and findings from health communication hold great potential to inform these developments, provided that the main current challenges in the field are adequately addressed. Aim: To recommend targets for research in health communication, focusing on qualitative methods, in the field of self-management of (complex) chronic conditions. Methods: A position paper based on a selective review of literature on self-management of chronic health conditions. Findings: To better support the development of tailored self-management programs, health communication research should: i) consider the existential dimension of self-management behavior; ii) recognize and address the fact that we live in an information landscape characterized by information overload and infodemic, and iii) apply qualitative methods to ensure that individuals' perspectives are fully taken into account. Discussion and conclusion: Gaining in-depth qualitative insights into the adjustment process for (complex) chronic health conditions is of mainstream importance for developing tailored communication interventions that can assist newly diagnosed individuals in integrating multiple self-management behaviors in their lives. This holds great potential to improve health outcomes for individuals and to reduce costs for society.&nbsp

Speculative computation: application scenarios

Artificial intelligence and machine learning have been widely applied in several areas with the twofold goal of improving people’s well-being and accelerating computational processes. This may be seen in medical assistance (e.g., automatic verification of MRI images) and in personal assistants that adapt the content to the user based on his/her preferences, to optimize query response times in relational databases and accelerate the information retrieval process. Most of machine learning algorithms used need a dataset to train on, so that the resulting models can be used, for example, to predict a value or enable user-specific results. Considering predictive methods, when new data arrives, a new training of the model may be needed. Speculative computation is a machine learning subfield that seeks to enable computation to be one step ahead of the user by speculating the value that will be received to be computed. A change in the environment may affect the execution, but the adjustments are rapidly performed. This paper intends to provide an overview of the field of speculative computation, describing its main characteristics and advantages, and different scenarios of the medical field in which it is applied. It also provides a critical and comparative analysis with other machine learning methods and a description of how to apply different algorithms to create better systems.This work has been supported by national funds through FCT - Fundação para a Ciência e a Tecnologia within the Project Scope: UIDB/00319/2020 and UIDB/04728/2020