Enabling ubiquitous data mining in intensive care: Features selection and data pre-processing

Ubiquitous Data Mining and Intelligent Decision Support Systems are gaining interest by both computer science researchers and intensive care doctors. Previous work contributed with Data Mining models to predict organ failure and outcome of patients in order to support and guide the clinical decision based on the notion of critical events and the data collected from monitors in real-time. This paper addresses the study of the impact of the Modified Early Warning Score, a simple physiological score that may allow improvements in the quality and safety of management provided to surgical ward patients, in the prediction sensibility. The feature selection and data pre-processing are also detailed. Results show that for some variables associated to this score the impact is minimal.Fundação para a Ciência e a Tecnologia (FCT

Critical events in mechanically ventilated patients

Mechanical Ventilation is an artificial way to help a Patient to breathe. This procedure is used to support patients with respiratory diseases however in many cases it can provoke lung damages, Acute Respiratory Diseases or organ failure. With the goal to early detect possible patient breath problems a set of limit values was defined to some variables monitored by the ventilator (Average Ventilation Pressure, Compliance Dynamic, Flow, Peak, Plateau and Support Pressure, Positive end-expiratory pressure, Respiratory Rate) in order to create critical events. A critical event is verified when a patient has a value higher or lower than the normal range defined for a certain period of time. The values were defined after elaborate a literature review and meeting with physicians specialized in the area. This work uses data streaming and intelligent agents to process the values collected in real-time and classify them as critical or not. Real data provided by an Intensive Care Unit were used to design and test the solution. In this study it was possible to understand the importance of introduce critical events for Mechanically Ventilated Patients. In some cases a value is considered critical (can trigger an alarm) however it is a single event (instantaneous) and it has not a clinical significance for the patient. The introduction of critical events which crosses a range of values and a pre-defined duration contributes to improve the decision-making process by decreasing the number of false positives and having a better comprehension of the patient condition.- Fundação para a Ciência e Tecnologia within the Project Scope UID/CEC/00319/2013 . The authors would like to thank FCT (Foundation of Science and Technology, Portugal) for the financial support through the contract PTDC/EEI-SII/1302/2012 (INTCare II

Knowledge discovery for pervasive and real-time intelligent decision support in intensive care medicine

Pervasiveness, real-time and online processing are important requirements included in the researchers’ agenda for the development of future generation of Intelligent Decision Support Systems (IDSS). In particular, knowledge discovery based IDSS operating in critical environments such of intensive care, should be adapted to those new requests. This paper introduces the way how INTCare, an IDSS developed in the intensive care unit of the Centro Hospitalar do Porto, will accommodate the new functionalities. Solutions are proposed for the most important constraints, e.g., paper based data, missing values, values out- of-range, data integration, data quality. The benefits and limitations of the approach are discussed.Fundação para a Ciência e a Tecnologia (FCT) - PTDC/EIA/72819/ 2006, SFRH/BD/70156/201

Predicting inpatient length of stay in a Portuguese hospital using the CRISP-DM methodology

Com base nos dados disponíveis num hospital português relativos aos processos de internamento, ocorridos no período de 2000 a 2013, e seguindo a metodologia de data mining CRISP-DM, obteve-se um modelo de previsão dos tempos de internamento baseado no algoritmo random forest que apresentou uma elevada qualidade, e superior à obtida com outras técnicas de data mining, e que permitiu identificar os atributos clínicos do paciente como os mais importantes para a explicação dos tempos de internamento.Using data collected from a Portuguese hospital, within the period 2000 to 2013, we adopted the CRISP-DM methodology to predict inpatient length of stay. The best method (random forest algorithm) achieved a high quality prediction. Such model allowed the identification of the most relevant input features, which are related with the patients’ clinical attributes.(undefined

Regression Models of the Nuclear Power Unit VVER-1000 Using Data Mining Techniques

Due to plenty of changes in many interrelated processes at nuclear power plants there is the need to show which values of some parameters of the nuclear power plant with VVER-1000 are better. In this task data mining techniques can be introduced. In order to obtain regression models of nuclear power plant with VVER-1000 algorithms such as the Linear Regression, REPTree, and M5P were selected and the datasets were obtained by simulating two control programs in Simulink software. The study focused on such targets as the average temperature of the coolant in the first circuit and the output power of the power generator. This study demonstrates the good results of the correlation coefficients and the root relative squared error metrics in case of the improved compromise-combined control program in comparison with the control program with the constant average temperature of the coolant in the reactor core. In terms of the results the root relative squared error metric is less than 2.8% and the correlation coefficients had values higher than 99,95%. The use of these models can contribute to improving the understanding of the internal processes because using the best regression data mining models allows to see advantages of the improved compromise-combined control program.- This work has been supported by FCT - Fundacao para a Ciencia e Tecnologia within the Project Scope UID/CEC/00319/2013.info:eu-repo/semantics/publishedVersio

E-health-IoT Universe: A Review

The Internet of Things (IoT) devices are able to collect and share data directly with other devices through the cloud environment, providing a huge amount of information to be gathered, stored and analyzed for data-analytics processes. The scenarios in which the IoT devices may be useful are amazing varying, from automotive, to industrial automation or remote monitoring of domestic environment. Furthermore, has been proved that healthcare applications represent an important field of interest for IoT devices, due to the capability of improving the access to care, reducing the cost of healthcare and most importantly increasing the quality of life of the patients. In this paper, we analyze the state-of-art of IoT in medical environment, illustrating an extended range of IoT-driven healthcare applications that, however, still need innovative and high technology-based solutions to be considered ready to market. In particular, problems regarding characteristics of response-time and precision will be examined.  Furthermore, wearable and energy saving properties will be investigated in this paper and also the IT architectures able to ensure security and privacy during the all data-transmission process. Finally, considerations about data mining applications, such as risks prediction, classification and clustering will be provided, that are considered fundamental issues to ensure the accuracy of the care processes

e health iot universe a review

The Internet of Things (IoT) devices are able to collect and share data directly with other devices through the cloud environment, providing a huge amount of information to be gathered, stored and analyzed for data-analytics processes. The scenarios in which the IoT devices may be useful are amazing varying, from automotive, to industrial automation or remote monitoring of domestic environment. Furthermore, has been proved that healthcare applications represent an important field of interest for IoT devices, due to the capability of improving the access to care, reducing the cost of healthcare and most importantly increasing the quality of life of the patients. In this paper, we analyze the state-of-art of IoT in medical environment, illustrating an extended range of IoT-driven healthcare applications that, however, still need innovative and high technology-based solutions to be considered ready to market. In particular, problems regarding characteristics of response-time and precision will be examined. Furthermore, wearable and energy saving properties will be investigated in this paper and also the IT architectures able to ensure security and privacy during the all data-transmission process. Finally, considerations about data mining applications, such as risks prediction, classification and clustering will be provided, that are considered fundamental issues to ensure the accuracy of the care processes

Pervasive intelligent decision support in critical health care

Tese de doutoramento (área de especialização em Tecnologias e Sistemas de Informação)Intensive Care Units (ICU) are recognized as being critical environments, due to the fact that patients admitted to these units typically find themselves in situations of organ failure or serious health conditions. ICU professionals (doctors and nurses) dedicate most of their time taking care for the patients, relegating to a second plan all documentation tasks. Tasks such as recording vital signs, treatment planning and calculation of indicators, are only performed when patients are in a stable clinical condition. These records can occur with a lag of several hours. Since this is a critical environment, the Process of Decision Making (PDM) has to be fast, objective and effective. Any error or delay in the implementation of a particular decision may result in the loss of a human life. Aiming to minimize the human effort in bureaucratic processes and improve the PDM, dematerialization of information is required, eliminating paper-based recording and promoting an automatic registration of electronic and real-time data of patients. These data can then be used as a complement to the PDM, e.g. in Decision Support Systems that use Data Mining (DM) models. At the same time it is important for PDM to overcome barriers of time and space, making the platforms as universal as possible, accessible anywhere and anytime, regardless of the devices used. In this sense, it has been observed a proliferation of pervasive systems in healthcare. These systems are focused on providing healthcare to anyone, anytime and anywhere by removing restrictions of time and place, increasing both the coverage and quality of health care. This approach is mainly based on information that is stored and available online. With the aim of supporting the PDM a set of tests were carried out using static DM models making use of data that had been collected and entered manually in Euricus database. Preliminary results of these tests showed that it was possible to predict organ failure and outcome of a patient using DM techniques considering a set of physiological and clinical variables as input. High rates of sensitivity were achieved: Cardiovascular - 93.4%; Respiratory - 96.2%; Renal - 98.1%; Liver - 98.3%; hematologic - 97.5%; and Outcome and 98.3%. Upon completion of this study a challenge emerged: how to achieve the same results but in a dynamic way and in real time? A research question has been postulated as: "To what extent, Intelligent Decision Support Systems (IDSS) may be appropriate for critical clinical settings in a pervasive way? “. Research work included: 1. To percept what challenges a universal approach brings to IDSS, in the context of critical environments; 2. To understand how pervasive approaches can be adapted to critical environments; 3. To develop and test predictive models for pervasive approaches in health care. The main results achieved in this work made possible: 1. To prove the adequacy of pervasive approach in critical environments; 2. To design a new architecture that includes the information requirements for a pervasive approach, able to automate the process of knowledge discovery in databases; 3. To develop models to support pervasive intelligent decision able to act automatically and in real time. To induce DM ensembles in real time able to adapt autonomously in order to achieve predefined quality thresholds (total error = 85 % and accuracy > = 60 %). Main contributions of this work include new knowledge to help overcoming the requirements of a pervasive approach in critical environments. Some barriers inherent to information systems, like the acquisition and processing of data in real time and the induction of adaptive ensembles in real time using DM, have been broken. The dissemination of results is done via devices located anywhere and anytime.As Unidades de Cuidados Intensivos (UCIs) são conhecidas por serem ambientes críticos, uma vez que os doentes admitidos nestas unidades encontram-se, tipicamente, em situações de falência orgânica ou em graves condições de saúde. Os profissionais das UCIs (médicos e enfermeiros) dedicam a maioria do seu tempo no cuidado aos doentes, relegando para segundo plano todas as tarefas relacionadas com documentação. Tarefas como o registo dos sinais vitais, o planeamento do tratamento e o cálculo de indicadores são apenas realizados quando os doentes se encontram numa situação clínica estável. Devido a esta situação, estes registos podem ocorrer com um atraso de várias horas. Dado que este é um ambiente crítico, o Processo de Tomada de Decisão (PTD) tem de ser rápido, objetivo e eficaz. Qualquer erro ou atraso na implementação de uma determinada decisão pode resultar na perda de uma vida humana. Com o intuito de minimizar os esforços humanos em processos burocráticos e de otimizar o PTD, é necessário proceder à desmaterialização da informação, eliminando o registo em papel, e promover o registo automático e eletrónico dos dados dos doentes obtidos em tempo real. Estes dados podem, assim, ser usados com um complemento ao PTD, ou seja, podem ser usados em Sistemas de Apoio à Decisão que utilizem modelos de Data Mining (DM). Ao mesmo tempo, é imperativo para o PTD superar barreiras ao nível de tempo e espaço, desenvolvendo plataformas tão universais quanto possíveis, acessíveis em qualquer lugar e a qualquer hora, independentemente dos dispositivos usados. Nesse sentido, tem-se verificado uma proliferação dos sistemas pervasive na saúde. Estes sistemas focam-se na prestação de cuidados de saúde a qualquer pessoa, a qualquer altura e em qualquer lugar através da eliminação das restrições ao nível do tempo e espaço, aumentando a cobertura e a qualidade na área da saúde. Esta abordagem é, principalmente, baseada em informações que estão armazenadas disponíveis online. Com o objetivo de suportar o PTD, foi realizado um conjunto de testes com modelos de DM estáticos, recorrendo a dados recolhidos e introduzidos manualmente na base de dados “Euricus”. Os resultados preliminares destes testes mostraram que era possível prever a falência orgânica ou a alta hospitalar de um doente, através de técnicas de DM utilizando como valores de entrada um conjunto de variáveis clínicas e fisiológicas. Nos testes efetuados, foram obtidos elevados níveis de sensibilidade: cardiovascular - 93.4%; respiratório - 96.2%; renal - 98.1%; hepático - 98.3%; hematológico - 97.5%; e alta hospitalar - 98.3%. Com a finalização deste estudo, observou-se o aparecimento de um novo desafio: como alcançar os mesmos resultados mas em modo dinâmico e em tempo real? Uma questão de investigação foi postulada: “Em que medida os Sistemas de Apoio à Decisão Inteligentes (SADIs) podem ser adequados às configurações clínicas críticas num modo pervasive?”. Face ao exposto, o trabalho de investigação inclui os seguintes pontos: 1. Perceber quais os desafios que uma abordagem universal traz para os SADIs, no contexto dos ambientes críticos; 2. Compreender como as abordagens pervasive podem ser adaptadas aos ambientes críticos; 3. Desenvolver e testar modelos de previsão para abordagens pervasive na área da saúde. Os principais resultados alcançados neste trabalho tornaram possível: 1. Provar a adequação da abordagem pervasive em ambientes críticos; 2. Conceber uma nova arquitetura que inclui os requisitos de informação para uma abordagem pervasive, capaz de automatizar o processo de descoberta de conhecimento em base de dados; 3. Desenvolver modelos de suporte à decisão inteligente e pervasive, capazes de atuar automaticamente e em tempo real. Induzir ensembles DM em tempo real, capazes de se adaptarem de forma autónoma, com o intuito de alcançar as medidas de qualidade pré-definidas (erro total = 85 % e acuidade> = 60 %). As principais contribuições deste trabalho incluem novos conhecimentos para ajudar a ultrapassar as exigências de uma abordagem pervasive em ambientes críticos. Algumas barreiras inerentes aos sistemas de informação, como a aquisição e o processamento de dados em tempo real e a indução de ensembles adaptativos em tempo real utilizando DM, foram transpostas. A divulgação dos resultados é feita através de dispositivos localizados, em qualquer lugar e a qualquer hora.Intensive Care Units (ICU) are recognized as being critical environments, due to the fact that patients admitted to these units typically find themselves in situations of organ failure or serious health conditions. ICU professionals (doctors and nurses) dedicate most of their time taking care for the patients, relegating to a second plan all documentation tasks. Tasks such as recording vital signs, treatment planning and calculation of indicators, are only performed when patients are in a stable clinical condition. These records can occur with a lag of several hours. Since this is a critical environment, the Process of Decision Making (PDM) has to be fast, objective and effective. Any error or delay in the implementation of a particular decision may result in the loss of a human life. Aiming to minimize the human effort in bureaucratic processes and improve the PDM, dematerialization of information is required, eliminating paper-based recording and promoting an automatic registration of electronic and real-time data of patients. These data can then be used as a complement to the PDM, e.g. in Decision Support Systems that use Data Mining (DM) models. At the same time it is important for PDM to overcome barriers of time and space, making the platforms as universal as possible, accessible anywhere and anytime, regardless of the devices used. In this sense, it has been observed a proliferation of pervasive systems in healthcare. These systems are focused on providing healthcare to anyone, anytime and anywhere by removing restrictions of time and place, increasing both the coverage and quality of health care. This approach is mainly based on information that is stored and available online. With the aim of supporting the PDM a set of tests were carried out using static DM models making use of data that had been collected and entered manually in Euricus database. Preliminary results of these tests showed that it was possible to predict organ failure and outcome of a patient using DM techniques considering a set of physiological and clinical variables as input. High rates of sensitivity were achieved: Cardiovascular - 93.4%; Respiratory - 96.2%; Renal - 98.1%; Liver - 98.3%; hematologic - 97.5%; and Outcome and 98.3%. Upon completion of this study a challenge emerged: how to achieve the same results but in a dynamic way and in real time? A research question has been postulated as: "To what extent, Intelligent Decision Support Systems (IDSS) may be appropriate for critical clinical settings in a pervasive way? “. Research work included: 1. To percept what challenges a universal approach brings to IDSS, in the context of critical environments; 2. To understand how pervasive approaches can be adapted to critical environments; 3. To develop and test predictive models for pervasive approaches in health care. The main results achieved in this work made possible: 1. To prove the adequacy of pervasive approach in critical environments; 2. To design a new architecture that includes the information requirements for a pervasive approach, able to automate the process of knowledge discovery in databases; 3. To develop models to support pervasive intelligent decision able to act automatically and in real time. To induce DM ensembles in real time able to adapt autonomously in order to achieve predefined quality thresholds (total error = 85 % and accuracy > = 60 %). Main contributions of this work include new knowledge to help overcoming the requirements of a pervasive approach in critical environments. Some barriers inherent to information systems, like the acquisition and processing of data in real time and the induction of adaptive ensembles in real time using DM, have been broken. The dissemination of results is done via devices located anywhere and anytime

Previsão de tempos de internamento de pacientes via técnicas de data mining

Há mais de duas décadas que os hospitais começaram a armazenar a informação clínica electrónica nos seus sistemas de informação hospitalar. Cada vez mais, os hospitais recolhem grandes quantidades de dados através de novos métodos electrónicos de armazenamento de dados, permitindo o aumento do interesse nas áreas da descoberta de conhecimento em bases de dados e data mining (DM). Existe então a necessidade de investigar melhores métodos de análise de dados e automatizar esses procedimentos de modo a facilitar a criação de conhecimento. No passado, objetivos como a necessidade de reduzir o tempo de internamento, aumentar o número de camas disponíveis para novos internamentos, reduzir o tempo de espera na lista de espera cirúrgica e prestar melhores cuidados de saúde têm sido difíceis de cumprir. O DM é então o processo chave neste trabalho através da aplicação de algoritmos de aprendizagem. Esta dissertação irá focar-se no estudo de caso de uma instituição hospitalar nacional, com base nos dados oriundos do processo de internamento hospitalar entre 2001 e 2013. Obteve-se um modelo preditivo para tempos de internamento através da descoberta de comportamentos e padrões existentes no processo de internamento hospitalar, com base em técnicas de DM. A concepção de um modelo explicativo permitiu extrair conhecimento útil para a área de negócio hospitalar, possibilitando no futuro, a execução de um processo de internamento mais eficiente, otimizando o número de camas existentes no contexto hospitalar e evitando erros ou desvios no planeamento dos internamentos.For more than two decades that hospitals began storing information related with electronic clinical information systems. Increasingly, hospitals collect large amounts of data through new methods of electronic data storage, allowing increased interest in the areas of knowledge discovery in databases and data mining (DM). There is thus a need to investigate improved methods of data analysis and automate these procedures to facilitate the creation of knowledge. In the past, objectives such as the need to reduce the length of stay, increase the number of beds available for new admissions, reduce the wait time on the waiting list and provide the best surgical care has been difficult to meet. DM is then the key process in this work by applying learning algorithms. This dissertation will focus on the case study of a national hospital, based on data from the process of hospitalization between 2001 and 2013. A predictive model was obtained for the length of stay, through the discovery of behaviors and patterns existing in the hospitalization process, based on DM techniques. The design of an explanatory model allowed extracting useful knowledge for hospital management, enabling the implementation of a rigorous admission process, optimizing the number of available hospital beds and avoiding errors or deviations in the admission plans