Methods to Facilitate the Capture, Use, and Reuse of Structured and Unstructured Clinical Data.

Electronic health records (EHRs) have great potential to improve quality of care and to support clinical and translational research. While EHRs are being increasingly implemented in U.S. hospitals and clinics, their anticipated benefits have been largely unachieved or underachieved. Among many factors, tedious documentation requirements and the lack of effective information retrieval tools to access and reuse data are two key reasons accounting for this deficiency. In this dissertation, I describe my research on developing novel methods to facilitate the capture, use, and reuse of both structured and unstructured clinical data. Specifically, I develop a framework to investigate potential issues in this research topic, with a focus on three significant challenges. The first challenge is structured data entry (SDE), which can be facilitated by four effective strategies based on my systematic review. I further propose a multi-strategy model to guide the development of future SDE applications. In the follow-up study, I focus on workflow integration and evaluate the feasibility of using EHR audit trail logs for clinical workflow analysis. The second challenge is the use of clinical narratives, which can be supported by my innovative information retrieval (IR) technique called “semantically-based query recommendation (SBQR)”. My user experiment shows that SBQR can help improve the perceived performance of a medical IR system, and may work better on search tasks with average difficulty. The third challenge involves reusing EHR data as a reference standard to benchmark the quality of other health-related information. My study assesses the readability of trial descriptions on ClinicalTrials.gov and found that trial descriptions are very hard to read, even harder than clinical notes. My dissertation has several contributions. First, it conducts pioneer studies with innovative methods to improve the capture, use, and reuse of clinical data. Second, my dissertation provides successful examples for investigators who would like to conduct interdisciplinary research in the field of health informatics. Third, the framework of my research can be a great tool to generate future research agenda in clinical documentation and EHRs. I will continue exploring innovative and effective methods to maximize the value of EHRs.PHDInformationUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/135845/1/tzuyu_1.pd

Impact of EHR Usability on Provider Efficiency and Patient Safety in Non-Hospital Settings

Healthcare organizations may reap benefits transitioning to electronic health records (EHRs), such as decreased healthcare costs and better care. However, severe unintended consequences from implementation and design of these systems have emerged. Poorly implemented EHR systems may endanger the integrity of clinical or administrative data. That, in turn, can lead to errors jeopardizing patient safety or quality of care. A literature review of 40 sources identified how EHR implementation and design can impact provider centric, patient centric, and outcomes. These categories provided the basis for a comprehensive EHR impact model that was evaluated in non-hospital settings through focus groups interviews

A customized semantic service retrieval methodology for the digital ecosystems environment

With the emergence of the Web and its pervasive intrusion on individuals, organizations, businesses etc., people now realize that they are living in a digital environment analogous to the ecological ecosystem. Consequently, no individual or organization can ignore the huge impact of the Web on social well-being, growth and prosperity, or the changes that it has brought about to the world economy, transforming it from a self-contained, isolated, and static environment to an open, connected, dynamic environment. Recently, the European Union initiated a research vision in relation to this ubiquitous digital environment, known as Digital (Business) Ecosystems. In the Digital Ecosystems environment, there exist ubiquitous and heterogeneous species, and ubiquitous, heterogeneous, context-dependent and dynamic services provided or requested by species. Nevertheless, existing commercial search engines lack sufficient semantic supports, which cannot be employed to disambiguate user queries and cannot provide trustworthy and reliable service retrieval. Furthermore, current semantic service retrieval research focuses on service retrieval in the Web service field, which cannot provide requested service retrieval functions that take into account the features of Digital Ecosystem services. Hence, in this thesis, we propose a customized semantic service retrieval methodology, enabling trustworthy and reliable service retrieval in the Digital Ecosystems environment, by considering the heterogeneous, context-dependent and dynamic nature of services and the heterogeneous and dynamic nature of service providers and service requesters in Digital Ecosystems.The customized semantic service retrieval methodology comprises: 1) a service information discovery, annotation and classification methodology; 2) a service retrieval methodology; 3) a service concept recommendation methodology; 4) a quality of service (QoS) evaluation and service ranking methodology; and 5) a service domain knowledge updating, and service-provider-based Service Description Entity (SDE) metadata publishing, maintenance and classification methodology.The service information discovery, annotation and classification methodology is designed for discovering ubiquitous service information from the Web, annotating the discovered service information with ontology mark-up languages, and classifying the annotated service information by means of specific service domain knowledge, taking into account the heterogeneous and context-dependent nature of Digital Ecosystem services and the heterogeneous nature of service providers. The methodology is realized by the prototype of a Semantic Crawler, the aim of which is to discover service advertisements and service provider profiles from webpages, and annotating the information with service domain ontologies.The service retrieval methodology enables service requesters to precisely retrieve the annotated service information, taking into account the heterogeneous nature of Digital Ecosystem service requesters. The methodology is presented by the prototype of a Service Search Engine. Since service requesters can be divided according to the group which has relevant knowledge with regard to their service requests, and the group which does not have relevant knowledge with regard to their service requests, we respectively provide two different service retrieval modules. The module for the first group enables service requesters to directly retrieve service information by querying its attributes. The module for the second group enables service requesters to interact with the search engine to denote their queries by means of service domain knowledge, and then retrieve service information based on the denoted queries.The service concept recommendation methodology concerns the issue of incomplete or incorrect queries. The methodology enables the search engine to recommend relevant concepts to service requesters, once they find that the service concepts eventually selected cannot be used to denote their service requests. We premise that there is some extent of overlap between the selected concepts and the concepts denoting service requests, as a result of the impact of service requesters’ understandings of service requests on the selected concepts by a series of human-computer interactions. Therefore, a semantic similarity model is designed that seeks semantically similar concepts based on selected concepts.The QoS evaluation and service ranking methodology is proposed to allow service requesters to evaluate the trustworthiness of a service advertisement and rank retrieved service advertisements based on their QoS values, taking into account the contextdependent nature of services in Digital Ecosystems. The core of this methodology is an extended CCCI (Correlation of Interaction, Correlation of Criterion, Clarity of Criterion, and Importance of Criterion) metrics, which allows a service requester to evaluate the performance of a service provider in a service transaction based on QoS evaluation criteria in a specific service domain. The evaluation result is then incorporated with the previous results to produce the eventual QoS value of the service advertisement in a service domain. Service requesters can rank service advertisements by considering their QoS values under each criterion in a service domain.The methodology for service domain knowledge updating, service-provider-based SDE metadata publishing, maintenance, and classification is initiated to allow: 1) knowledge users to update service domain ontologies employed in the service retrieval methodology, taking into account the dynamic nature of services in Digital Ecosystems; and 2) service providers to update their service profiles and manually annotate their published service advertisements by means of service domain knowledge, taking into account the dynamic nature of service providers in Digital Ecosystems. The methodology for service domain knowledge updating is realized by a voting system for any proposals for changes in service domain knowledge, and by assigning different weights to the votes of domain experts and normal users.In order to validate the customized semantic service retrieval methodology, we build a prototype – a Customized Semantic Service Search Engine. Based on the prototype, we test the mathematical algorithms involved in the methodology by a simulation approach and validate the proposed functions of the methodology by a functional testing approach

CHORUS Deliverable 2.2: Second report - identification of multi-disciplinary key issues for gap analysis toward EU multimedia search engines roadmap

After addressing the state-of-the-art during the first year of Chorus and establishing the existing landscape in multimedia search engines, we have identified and analyzed gaps within European research effort during our second year. In this period we focused on three directions, notably technological issues, user-centred issues and use-cases and socio- economic and legal aspects. These were assessed by two central studies: firstly, a concerted vision of functional breakdown of generic multimedia search engine, and secondly, a representative use-cases descriptions with the related discussion on requirement for technological challenges. Both studies have been carried out in cooperation and consultation with the community at large through EC concertation meetings (multimedia search engines cluster), several meetings with our Think-Tank, presentations in international conferences, and surveys addressed to EU projects coordinators as well as National initiatives coordinators. Based on the obtained feedback we identified two types of gaps, namely core technological gaps that involve research challenges, and “enablers”, which are not necessarily technical research challenges, but have impact on innovation progress. New socio-economic trends are presented as well as emerging legal challenges

Automatic Generation of Personalized Recommendations in eCoaching

Denne avhandlingen omhandler eCoaching for personlig livsstilsstøtte i sanntid ved bruk av informasjons- og kommunikasjonsteknologi. Utfordringen er å designe, utvikle og teknisk evaluere en prototyp av en intelligent eCoach som automatisk genererer personlige og evidensbaserte anbefalinger til en bedre livsstil. Den utviklede løsningen er fokusert på forbedring av fysisk aktivitet. Prototypen bruker bærbare medisinske aktivitetssensorer. De innsamlede data blir semantisk representert og kunstig intelligente algoritmer genererer automatisk meningsfulle, personlige og kontekstbaserte anbefalinger for mindre stillesittende tid. Oppgaven bruker den veletablerte designvitenskapelige forskningsmetodikken for å utvikle teoretiske grunnlag og praktiske implementeringer. Samlet sett fokuserer denne forskningen på teknologisk verifisering snarere enn klinisk evaluering.publishedVersio

CHORUS Deliverable 2.1: State of the Art on Multimedia Search Engines

Based on the information provided by European projects and national initiatives related to multimedia search as well as domains experts that participated in the CHORUS Think-thanks and workshops, this document reports on the state of the art related to multimedia content search from, a technical, and socio-economic perspective. The technical perspective includes an up to date view on content based indexing and retrieval technologies, multimedia search in the context of mobile devices and peer-to-peer networks, and an overview of current evaluation and benchmark inititiatives to measure the performance of multimedia search engines. From a socio-economic perspective we inventorize the impact and legal consequences of these technical advances and point out future directions of research

Ontology-based personalisation of e-learning resources for disabled students

Students with disabilities are often expected to use e-learning systems to access learning materials but most systems do not provide appropriate adaptation or personalisation to meet their needs.The difficulties related to inadaptability of current learning environments can now be resolved using semantic web technologies such as web ontologies which have been successfully used to drive e-learning personalisation. Nevertheless, e-learning personalisation for students with disabilities has mainly targeted those with single disabilities such as dyslexia or visual impairment, often neglecting those with multiple disabilities due to the difficulty of designing for a combination of disabilities.This thesis argues that it is possible to personalise learning materials for learners with disabilities, including those with multiple disabilities. This is achieved by developing a model that allows the learning environment to present the student with learning materials in suitable formats while considering their disability and learning needs through an ontology-driven and disability-aware personalised e-learning system model (ONTODAPS). A disability ontology known as the Abilities and Disabilities Ontology for Online LEarning and Services (ADOOLES) is developed and used to drive this model. To test the above hypothesis, some case studies are employed to show how the model functions for various individuals with and without disabilities and then the implemented visual interface is experimentally evaluated by eighteen students with disabilities and heuristically by ten lecturers. The results are collected and statistically analysed.The results obtained confirm the above hypothesis and suggest that ONTODAPS can be effectively employed to personalise learning and to manage learning resources. The student participants found that ONTODAPS could aid their learning experience and all agreed that they would like to use this functionality in an existing learning environment. The results also suggest that ONTODAPS provides a platform where students with disabilities can have equivalent learning experience with their peers without disabilities. For the results to be generalised, this study could be extended through further experiments with more diverse groups of students with disabilities and across multiple educational institutions

Linked Data Entity Summarization

On the Web, the amount of structured and Linked Data about entities is constantly growing. Descriptions of single entities often include thousands of statements and it becomes difficult to comprehend the data, unless a selection of the most relevant facts is provided. This doctoral thesis addresses the problem of Linked Data entity summarization. The contributions involve two entity summarization approaches, a common API for entity summarization, and an approach for entity data fusion

An enhanced concept based approach medical information retrieval to address readability, vocabulary and presentation issues

Querying of health information retrieval for health advice has now become a general and notable task performed by individuals on the Internet. However, the failure of the existing approaches to integrate program modules that would address the information needs of all categories of end-users remains. This study focused on proposing an improved framework and designing an enhanced concept based approach (ECBA) for medical information retrieval that would better address readability, vocabulary mismatched and presentation issues by generating medical discharge documents and medical search queries results in both medical expert and layman’s forms. Three special program modules were designed and integrated in the enhanced concept based approach namely: medical terms control module, vocabulary controlled module and readability module to specifically address the information needs of both medical experts and laymen end-users. Eight benched marked datasets namely: Medline, UMLS, MeSH, Metamap, Metathesaurus, Diagnosia 7, Khresmoi Project 6 and Genetic Home Reference were used in validating the systems performance. Additionally, the ECBA was compared using three existing approaches such as concept based approach (CBA), query likelihood model (QLM) and latent semantic indexing (LSI). The evaluation was conducted using the performance and statistical metrics: P@40, NDCG@40, MAP, Analysis of Variance (ANOVA) and Turkey HSD Tests. The outcome of the final experimental results obtained shows that, the ECBA consistently obtained above 93% accuracy rate results on Medline, UMLS and MeSH Datasets, 92% on Metamap, Metathesaurus and Diagnosia 7 datasets and 91% on Khresmoi Project 6 and Genetic Home Reference datasets. Also, the statistical analysis performance results obtained by each of the four approaches: ECBA, CBA, QLM and LSI shows that, there is a significant difference among their Mean Scores, hence, the null hypothesis of no significant difference was rejected