Reading and arithmetic in adolescents with autism spectrum disorders: Peaks and dips in attainment

In describing academic attainment in autism spectrum disorders (ASD), results are typically reported at the group mean level. This may mask subgroups of individuals for whom academic achievement is incommensurate with intellectual ability. The authors tested the IQ, literacy, and mathematical abilities of a large group (N = 100) of adolescents (14–16 years old) with ASD. Seventy-three percent of the sample had at least one area of literacy or mathematical achievement that was highly discrepant (approximately 14 standard score points) from full-scale IQ (FSIQ). The authors focused on four subgroups with either word reading (“Reading Peak” and “Reading Dip”) or arithmetic (“Arithmetic Peak” and “Arithmetic Dip”) higher or lower than FSIQ. These subgroups were largely mutually exclusive and were characterized by distinct intellectual profiles. The largest was the “Arithmetic Peak” subgroup of participants, who presented with average intellectual ability alongside superior arithmetic skills and who were predominantly in a mainstream educational setting. Overall, the most pervasive profile was discrepantly poor reading comprehension, which associated with severity of social and communication difficulties. The high rate of uneven academic attainment in ASD has implications for educational practice

Virtual patients design and its effect on clinical reasoning and student experience : a protocol for a randomised factorial multi-centre study

Background Virtual Patients (VPs) are web-based representations of realistic clinical cases. They are proposed as being an optimal method for teaching clinical reasoning skills. International standards exist which define precisely what constitutes a VP. There are multiple design possibilities for VPs, however there is little formal evidence to support individual design features. The purpose of this trial is to explore the effect of two different potentially important design features on clinical reasoning skills and the student experience. These are the branching case pathways (present or absent) and structured clinical reasoning feedback (present or absent). Methods/Design This is a multi-centre randomised 2x2 factorial design study evaluating two independent variables of VP design, branching (present or absent), and structured clinical reasoning feedback (present or absent).The study will be carried out in medical student volunteers in one year group from three university medical schools in the United Kingdom, Warwick, Keele and Birmingham. There are four core musculoskeletal topics. Each case can be designed in four different ways, equating to 16 VPs required for the research. Students will be randomised to four groups, completing the four VP topics in the same order, but with each group exposed to a different VP design sequentially. All students will be exposed to the four designs. Primary outcomes are performance for each case design in a standardized fifteen item clinical reasoning assessment, integrated into each VP, which is identical for each topic. Additionally a 15-item self-reported evaluation is completed for each VP, based on a widely used EViP tool. Student patterns of use of the VPs will be recorded. In one centre, formative clinical and examination performance will be recorded, along with a self reported pre and post-intervention reasoning score, the DTI. Our power calculations indicate a sample size of 112 is required for both primary outcomes

CBR and MBR techniques: review for an application in the emergencies domain

The purpose of this document is to provide an in-depth analysis of current reasoning engine practice and the integration strategies of Case Based Reasoning and Model Based Reasoning that will be used in the design and development of the RIMSAT system. RIMSAT (Remote Intelligent Management Support and Training) is a European Commission funded project designed to: a.. Provide an innovative, 'intelligent', knowledge based solution aimed at improving the quality of critical decisions b.. Enhance the competencies and responsiveness of individuals and organisations involved in highly complex, safety critical incidents - irrespective of their location. In other words, RIMSAT aims to design and implement a decision support system that using Case Base Reasoning as well as Model Base Reasoning technology is applied in the management of emergency situations. This document is part of a deliverable for RIMSAT project, and although it has been done in close contact with the requirements of the project, it provides an overview wide enough for providing a state of the art in integration strategies between CBR and MBR technologies.Postprint (published version

Diagnostic error increases mortality and length of hospital stay in patients presenting through the emergency room

Background: Diagnostic errors occur frequently, especially in the emergency room. Estimates about the consequences of diagnostic error vary widely and little is known about the factors predicting error. Our objectives thus was to determine the rate of discrepancy between diagnoses at hospital admission and discharge in patients presenting through the emergency room, the discrepancies’ consequences, and factors predicting them. Methods: Prospective observational clinical study combined with a survey in a University-affiliated tertiary care hospital. Patients’ hospital discharge diagnosis was compared with the diagnosis at hospital admittance through the emergency room and classified as similar or discrepant according to a predefined scheme by two independent expert raters. Generalized linear mixed-effects models were used to estimate the effect of diagnostic discrepancy on mortality and length of hospital stay and to determine whether characteristics of patients, diagnosing physicians, and context predicted diagnostic discrepancy. Results: 755 consecutive patients (322 [42.7%] female; mean age 65.14 years) were included. The discharge diagnosis differed substantially from the admittance diagnosis in 12.3% of cases. Diagnostic discrepancy was associated with a longer hospital stay (mean 10.29 vs. 6.90 days; Cohen’s d 0.47; 95% confidence interval 0.26 to 0.70; P = 0.002) and increased patient mortality (8 (8.60%) vs. 25(3.78%); OR 2.40; 95% CI 1.05 to 5.5 P = 0.038). A factor available at admittance that predicted diagnostic discrepancy was the diagnosing physician’s assessment that the patient presented atypically for the diagnosis assigned (OR 3.04; 95% CI 1.33–6.96; P = 0.009). Conclusions: Diagnostic discrepancies are a relevant healthcare problem in patients admitted through the emergency room because they occur in every ninth patient and are associated with increased in-hospital mortality. Discrepancies are not readily predictable by fixed patient or physician characteristics; attention should focus on context

A quantum geometric model of similarity

No other study has had as great an impact on the development of the similarity literature as that of Tversky (1977), which provided compelling demonstrations against all the fundamental assumptions of the popular, and extensively employed, geometric similarity models. Notably, similarity judgments were shown to violate symmetry and the triangle inequality, and also be subject to context effects, so that the same pair of items would be rated differently, depending on the presence of other items. Quantum theory provides a generalized geometric approach to similarity and can address several of Tversky’s (1997) main findings. Similarity is modeled as quantum probability, so that asymmetries emerge as order effects, and the triangle equality violations and the diagnosticity effect can be related to the context-dependent properties of quantum probability. We so demonstrate the promise of the quantum approach for similarity and discuss the implications for representation theory in general

Evaluating the Representational Hub of Language and Vision Models

The multimodal models used in the emerging field at the intersection of computational linguistics and computer vision implement the bottom-up processing of the `Hub and Spoke' architecture proposed in cognitive science to represent how the brain processes and combines multi-sensory inputs. In particular, the Hub is implemented as a neural network encoder. We investigate the effect on this encoder of various vision-and-language tasks proposed in the literature: visual question answering, visual reference resolution, and visually grounded dialogue. To measure the quality of the representations learned by the encoder, we use two kinds of analyses. First, we evaluate the encoder pre-trained on the different vision-and-language tasks on an existing diagnostic task designed to assess multimodal semantic understanding. Second, we carry out a battery of analyses aimed at studying how the encoder merges and exploits the two modalities.Comment: Accepted to IWCS 201

The effect of multiple knowledge sources on learning and teaching

Current paradigms for machine-based learning and teaching tend to perform their task in isolation from a rich context of existing knowledge. In contrast, the research project presented here takes the view that bringing multiple sources of knowledge to bear is of central importance to learning in complex domains. As a consequence teaching must both take advantage of and beware of interactions between new and existing knowledge. The central process which connects learning to its context is reasoning by analogy, a primary concern of this research. In teaching, the connection is provided by the explicit use of a learning model to reason about the choice of teaching actions. In this learning paradigm, new concepts are incrementally refined and integrated into a body of expertise, rather than being evaluated against a static notion of correctness. The domain chosen for this experimentation is that of learning to solve "algebra story problems." A model of acquiring problem solving skills in this domain is described, including: representational structures for background knowledge, a problem solving architecture, learning mechanisms, and the role of analogies in applying existing problem solving abilities to novel problems. Examples of learning are given for representative instances of algebra story problems. After relating our views to the psychological literature, we outline the design of a teaching system. Finally, we insist on the interdependence of learning and teaching and on the synergistic effects of conducting both research efforts in parallel