Towards a Personalised Health System

This paper presents a Personalized Healthcare System (PHS), a decision support tool that can adapt to changing conditions, such as aging and illness, in individual patients. The system consists of three components: a unique personalised profile, a collection of web based tools and a web based repository for managing interactions between clinicians and tools. The proposed system makes extensive use of software agents, both for collecting the initial information required to construct a personalized profile and for transporting the information needed to use the on-line decision support tools. The paper discusses the operation of a PHS and suggests possible implementation issues

Coupling Clinical Decision Support System with Computerized Prescriber Order Entry and their Dynamic Plugging in the Medical Workflow System

This work deals with coupling Clinical Decision Support System (CDSS) with Computerized Prescriber Order Entry (CPOE) and their dynamic plugging in the medical Workflow Management System (WfMS). First, in this paper we argue some existing CDSS representative of the state of the art in order to emphasize their inability to deal with coupling with CPOE and medical WfMS. The multi-agent technology is at the basis of our proposition since (i) it provides natural abstractions to deal with distribution, heterogeneity and autonomy which are inherent to the previous systems (CDSS, CPOE and medical WfMS), and (ii) it introduces powerful concepts such as organizations, goals and roles useful to describe in details the coordination of the different components involved in these systems. In this paper, we also propose a Multi-Agent System (MAS) to support the coupling CDSS with CPOE. Finally, we show how we integrate the proposed MAS in the medical workflow management system which is also based on collaborating agentsComment: International Conference on Information Technology and e-services, ICITeS'12, IEEE, March 24-26,Sousse-Tunisia, 201

Sistem Pendukung Keputusan Pemilihan Mahasiswa Penerima Beasiswa Lokal Manajemen Informatika Unmer Madiun menggunakan Weighted Product

Beasiswa merupakan dana bantuan yang diperuntukkan bagi anak yang berprestasi atau kurang mampu. Universitas Merdeka Madiun (Unmer Madiun) adalah salah satu Perguruan Tinggi Swasta di Jawa Timur yang memiliki program beasiswa lokal pada program studinya. Salah satu program studi di Unmer Madiun yang memiliki program beasiswa lokal adalah Manajemen Informatika. Beasiswa lokal diperuntukkan khusus mahasiswa Manajemen Informatika yang memiliki prestasi di bidang akademik. Untuk pemilihan mahasiswa yang menerima harus memenuhi beberapa kriteria, antara lain mahasiswa harus memiliki IPK di atas 3,00 , mahasiswa harus pernah menulis karya ilmiah, dan mahasiswa harus aktif dalam organisasi.  Sistem Pendukung Keputusan (SPK) yang berbasis teknologi informasi dapat digunakan untuk membantu pemilihan mahasiswa yang berhak menerima beasiswa lokal, Kriteria yang digunakan untuk pemilihan juga diterapkan dalam SPK pemilihan mahasiswa penerima beasiswa lokal. Untuk metode yang digunakan Sistem Pendukung Keputusan adalah Weighted Product. Sistem Pendukung Keputusan dibangun menggunakan metode Build and Fix, yang dianggap mampu membangun sistem secara cepat. Pada penelitian sistem pendukung keputusan pemilihan mahasiswa penerima beasiswa lokal program studi Manajemen Informatika, didapatkan hasil tingkat keberhasilan sistem sebesar 100% dengan pengujian Black Box. Berdasarkan keberhasilan yang dicapai, sistem dapat digunakan dalam membantu pemilihan mahasiswa yang berhak menerima beasiswa lokal

Comparing predictions made by a prediction model, clinical score, and physicians Pediatric asthma exacerbations in the emergency department

Background: Asthma exacerbations are one of the most common medical reasons for children to be brought to the hospital emergency department (ED). Various prediction models have been proposed to support diagnosis of exacerbations and evaluation of their severity. Objectives: First, to evaluate prediction models constructed from data using machine learning techniques and to select the best performing model. Second, to compare predictions from the selected model with predictions from the Pediatric Respiratory Assessment Measure (PRAM) score, and predictions made by ED physicians. Design: A two-phase study conducted in the ED of an academic pediatric hospital. In phase 1 data collected prospectively using paper forms was used to construct and evaluate five prediction models, and the best performing model was selected. In phase 2, data collected prospectively using a mobile system was used to compare the predictions of the selected prediction model with those from PRAM and ED physicians. Measurements: Area under the receiver operating characteristic curve and accuracy in phase 1; accuracy, sensitivity, specificity, positive and negative predictive values in phase 2. Results: In phase 1 prediction models were derived from a data set of 240 patients and evaluated using 10-fold cross validation. A naive Bayes (NB) model demonstrated the best performance and it was selected for phase 2. Evaluation in phase 2 was conducted on data from 82 patients. Predictions made by the NB model were less accurate than the PRAM score and physicians (accuracy of 70.7%, 73.2% and 78.0% respectively), however, according to McNemar’s test it is not possible to conclude that the differences between predictions are statistically significant. Conclusion: Both the PRAM score and the NB model were less accurate than physicians. The NB model can handle incomplete patient data and as such may complement the PRAM score. However, it requires further research to improve its accuracy

A Task-based Support Architecture for Developing Point-of-care Clinical Decision Support Systems for the Emergency Department

Objectives: The purpose of this study was to create a task-based support architecture for developing clinical decision support systems (CDSSs) that assist physicians in making decisions at the point-of-care in the emergency department (ED). The backbone of the proposed architecture was established by a task-based emergency workflow model for a patient-physician encounter. Methods: The architecture was designed according to an agent-oriented paradigm. Specifically, we used the O-MaSE (Organization-based Multi-agent System Engineering) method that allows for iterative translation of functional requirements into architectural components (e.g., agents). The agent-oriented paradigm was extended with ontology-driven design to implement ontological models representing knowledge required by specific agents to operate. Results: The task-based architecture allows for the creation of a CDSS that is aligned with the task-based emergency workflow model. It facilitates decoupling of executable components (agents) from embedded domain knowledge (ontological models), thus supporting their interoperability, sharing, and reuse. The generic architecture was implemented as a pilot system, MET3-AE – a CDSS to help with the management of pediatric asthma exacerbation in the ED. The system was evaluated in a hospital ED. Conclusions: The architecture allows for the creation of a CDSS that integrates support for all tasks from the task-based emergency workflow model, and interacts with hospital information systems. Proposed architecture also allows for reusing and sharing system components and knowledge across disease-specific CDSSs

Serviço de emergência médica angolano : optimização utilizando sistemas multi-agente

Tese de doutoramento, Informática (Engenharia Informática), Universidade de Lisboa, Faculdade de Ciências, 2015A temática da saúde é uma das que apresenta mais desafios em Angola. Os desafios são não só intrínsecos à própria área, mas resultam também de condicionantes externas. Uma das áreas mais problemáticas, dada a sua natureza complexa e multidisciplinar, é a dos serviços de emergências hospitalares. Visando um aumento de eficiência desses serviços, podem estudar e ensaiar-se várias políticas públicas, mas que, frequentemente, apenas podem ser avaliadas quando já se encontram implementadas. A simulação à priori dessas políticas apresenta vários benefícios: o design pode ser ajustado aos objectivos dos decisores políticos de forma mais exacta; as políticas podem reflectir melhor as motivações dos indivíduos envolvidos em diversos papéis (utilizadores, médicos, enfermeiros, funcionários públicos, auditores, decisores políticos); as ligações micro-macro e as mediações são representadas explicitamente; a simulação permite a melhoria sucessiva das políticas, de tal forma que as mesmas aquando da sua implementação estejam aperfeiçoadas; os decisores e intervenientes podem conhecer melhor o território de decisão tendo em vista uma economia de custos, um aumento da eficiência dos serviços, uma maior satisfação dos utentes e uma acção mais adequada em situações de contingência. Defendemos a simulação baseada em multi-agente como forma de orientar a especificação de políticas. Os sistemas multi-agente (SMA) permitem a representação de agentes racionais heterogéneos e fornecem uma abordagem para criar modelos dinâmicos complexos de fenómenos sociais. Ao longo dos últimos anos assistiu-se a um crescente interesse pela utilização dos SMA na área da prestação de cuidados de saúde. O potencial de flexibilidade, adaptabilidade e robustez dos SMA é amplamente considerado como uma mais-valia para a área da saúde em tópicos como o apoio à decisão médica, diagnóstico e monitorização de pacientes, prestação de cuidados remotos, gestão e coordenação de recursos ou aprendizagem e treino médicos. Nesta dissertação descreve-se como podemos atacar o problema de optimização das políticas de serviços de emergência médica, quando há uma diferença clara entre a concepção dessas políticas e o uso que as pessoas lhes dão. Apresenta-se o cenário e um modelo para a simulação, identificando os actores envolvidos, as medidas necessárias para avaliar os resultados multidimensionais da simulação e como se podem afinar as políticas e simulá-las antes da sua implementação no mundo real. Motivado pelo cenário mais eficiente resultante da simulação e por forma a validá-lo, implementou-se o protótipo SIEMA (Sistema Integrado de Emergências Médicas Angolanas) com a finalidade de apoiar a gestão de emergências médicas em Angola.Healthcare presents major challenges in Angola. These challenges are not only intrinsic to the area itself, but are also a consequence of external constraints. Medical emergency services, on account of their complex and multidisciplinary nature, are one of the most problematic areas. Aiming at an increase of efficiency of these services, various public policies can be studied and tested, but their results often can only be assessed when policies are already implemented. The simulation of these policies has several benefits: the design can be adjusted to the objectives of policy makers more accurately; policies can better reflect the motivations of the individuals involved in various roles (patients, doctors, nurses, hospital staff, auditors, policy makers); micro-macro links and mediations are represented explicitly. Simulation allows successive improvement of policies before their implementation; decision-makers and stakeholders can better understand the decision territory, namely concerning cost savings, increased service efficiency, greater user satisfaction and a more adequate action in contingency situations. We defend multi-agent based simulation as a way to guide the policy specification. Multi-agent systems (MAS) allow the representation of heterogeneous agents and provide a rational approach to create complex social phenomena dynamic models. The past few years have witnessed a growing interest in the use of MAS in health. The potential for flexibility, adaptability and robustness of MAS is widely regarded as an asset for healthcare on topics such as medical decision support, diagnosis and monitoring of patients, remote care, management and coordination of resources or learning and medical training. This thesis describes how we tackle the optimization of medical emergency services policies when there is a clear distance between the conception of policies and the use that people give them. We present the scenario and a model for the simulation, identify involved actors and fine-tuned and simulate policies before implementation in the real world. Motivated by the most efficient scenario resulting from the simulation and in order to validate it, we implemented a prototype (SIEMA) to support the management of medical emergencies in Angola

Sistema Inteligente de Ayuda a la Decisión para el Diagnóstico Temprano de la Meningitis

Fecha de lectura de Tesis Doctoral: 18 febrero 2020La meningitis es una enfermedad pandémica que sufren muchos países poco desarrollados, principalmente debido a la falta de recursos económicos. El tipo más grave de meningitis, la enfermedad meningocócica, exige una atención médica inmediata ya que retrasos en su diagnóstico aumentan el riesgo de mortalidad. Esta tesis propone un sistema inteligente de ayuda a la decisión, basado en una arquitectura de Sistemas Multiagente, con el objetivo de ayudar a los médicos en las diferentes etapas del diagnóstico precoz de la meningitis, a través, principalmente, de síntomas observables. El sistema integra tres componentes inteligentes que aplican técnicas de aprendizaje automático basadas en árboles y técnicas de ingeniería del conocimiento. En los estudios realizados en el marco de este trabajo para obtener estos modelos y validarlos, se emplearon un conjunto de datos reales constituido por 26.228 registros de pacientes con diagnóstico de meningitis, procedentes de Brasil. Los resultados ponen de manifiesto que el sistema es capaz de determinar con éxito si el paciente tiene meningitis, si esta es meningocócica y si es viral o bacteriana

Hierarchical Multi-Project Planning and Supply Chain Management: an Integrated Framework

This work focuses on the need for new knowledge to allow hierarchical multi-project management to be conducted in the construction industry, which is characterised by high uncertainty, fragmentation, complex decisions, dynamic changes and long-distance communication. A dynamic integrated project management approach is required at strategic, tactical and operational levels in order to achieve adaptability. The work sees the multi-project planning and control problem in the context of supply chain management at main contractor companies. A portfolio manager must select and prioritise the projects, bid and negotiate with a wide range of clients, while project managers are dealing with subcontractors, suppliers, etc whose relationships and collaborations are critical to the optimisation of schedules in which time, cost and safety (etc) criteria must be achieved. Literature review and case studies were used to investigate existing approaches to hierarchical multi-project management, to identify the relationships and interactions between the parties concerned, and to investigate the possibilities for integration. A system framework was developed using a multi-agent-system architecture and utilising procedures adapted from literature to deal with short, medium and long-term planning. The framework is based on in-depth case study and integrates time-cost trade-off for project optimisation with multi-attribute utility theory to facilitate project scheduling, subcontractor selection and bid negotiation at the single project level. In addition, at the enterprise level, key performance indicator rule models are devised to align enterprise supply chain configuration (strategic decision) with bid selection and bid preparation/negotiation (tactical decision) and project supply chain selection (operational decision). Across the hierarchical framework the required quantitative and qualitative methods are integrated for project scheduling, risk assessment and subcontractor evaluation. Thus, experience sharing and knowledge management facilitate project planning across the scattered construction sites. The mathematical aspects were verified using real data from in-depth case study and a test case. The correctness, usefulness and applicability of the framework for users was assessed by creating a prototype Multi Agent System-Decision Support System (MAS-DSS) which was evaluated empirically with four case studies in national, international, large and small companies. The positive feedback from these cases indicates strong acceptance of the framework by experienced practitioners. It provides an original contribution to the literature on planning and supply chain management by integrating a practical solution for the dynamic and uncertain complex multi-project environment of the construction industry

Une approche logicielle du traitement de la dyslexie : étude de modèles et applications

Neuropsychological disorders are widespread and generate real public health problems. In particular in our modern society, where written communication is ubiquitous, dyslexia can be extremely disabling. Nevertheless we can note that the diagnosis and remediation of this pathology are fastidious and lack of standardization. Unfortunately it seems inherent to the clinical characterization of dyslexia by exclusion, to the multitude of different practitioners involved in such treatment and to the lack of objectivity of some existing methods. In this respect, we decided to investigate the possibilities offered by modern computing to overcome these barriers. Indeed we have assumed that the democratization of computer systems and their computing power could make of them a perfect tool to alleviate the difficulties encountered in the treatment of dyslexia. This research has led us to study the techniques software as well as hardware, which can conduct to the development of an inexpensive and scalable system able to attend a beneficial and progressive changing of practices in this pathology field. With this project we put ourselves definitely in an innovative stream serving quality of care and aid provided to people with disabilities. Our work has been identifying different improvement areas that the use of computers enables. Then each of these areas could then be the subject of extensive research, modeling and prototype developments. We also considered the methodology for designing this kind of system as a whole. In particular our thoughts and these accomplishments have allowed us to define a software framework suitable for implementing a software platform that we called the PAMMA. This platform should theoretically have access to all the tools required for the flexible and efficient development of medical applications integrating business processes. In this way it is expected that this system allows the development of applications for caring dyslexic patients thus leading to a faster and more accurate diagnosis and a more appropriate and effective remediation. Of our innovation efforts emerge encouraging perspectives. However such initiatives can only be achieved within multidisciplinary collaborations with many functional, technical and financial means. Creating such a consortium seems to be the next required step to get a funding necessary for realizing a first functional prototype of the PAMMA, as well as its first applications. Some clinical studies may be conducted to prove undoubtedly the effectiveness of such an approach for treating dyslexia and eventually other neuropsychological disorders.Les troubles neuropsychologiques sont très répandus et posent de réels problèmes de santé publique. En particulier, dans notre société moderne où la communication écrite est omniprésente, la dyslexie peut s’avérer excessivement handicapante. On remarque néanmoins que le diagnostic et la remédiation de cette pathologie restent délicats et manquent d’uniformisation. Ceci semble malheureusement inhérent à la caractérisation clinique par exclusion de la dyslexie, à la multitude de praticiens différents impliqués dans une telle prise en charge ainsi qu’au manque d’objectivité de certaines méthodes existantes. A ce titre, nous avons décidé d’investiguer les possibilités offertes par l’informatique actuelle pour surmonter ces barrières. Effectivement, nous avons supposé que la démocratisation des systèmes informatiques et leur puissance de calcul pourraient en faire un outil de choix pour pallier les difficultés rencontrées lors de la prise en charge de la dyslexie. Cette recherche nous a ainsi mené à étudier les techniques, aussi bien logicielles que matérielles, pouvant conduire au développement d’un système bon marché et évolutif qui serait capable d’assister un changement bénéfique et progressif des pratiques qui entourent cette pathologie. Avec ce projet, nous nous plaçons définitivement dans un courant innovant au service de la qualité des soins et des aides apportées aux personnes souffrant d’un handicap. Notre travail a ainsi consisté à identifier différents axes d’amélioration que l’utilisation de l’outil informatique rend possible. Chacun de ces axes a alors pu faire l’objet de recherches exhaustives, de modélisations et de développements de prototypes. Nous avons également réfléchi à la méthodologie à mettre en œuvre pour concevoir un tel système dans sa globalité. En particulier, nos réflexions et ces différents accomplissements nous ont permis de définir un framework logiciel propice à l’implémentation d’une plate-forme logicielle que nous avons appelée la PAMMA. Cette plate-forme devrait théoriquement pouvoir disposer de tous les outils permettant le développement souple et efficace d’applications médicales intégrant des processus métiers. Il est ainsi attendu de ce système qu’il permette le développement d’applications, pour la prise en charges des patients dyslexiques, conduisant à un diagnostic plus rapide et plus précis ainsi qu’à une remédiation plus adaptée et plus efficace. De notre effort d’innovation ressortent des perspectives encourageantes. Cependant, ce type d’initiative ne peut se concrétiser qu’autour de collaborations pluridisciplinaires disposant de nombreux moyens fonctionnels, techniques et financiers. La constitution d’un tel consortium semble donc être la prochaine étape nécessaire à l’obtention des financements pour réaliser un premier prototype fonctionnel de la PAMMA, ainsi que de premières applications. Des études cliniques pourront être alors menées pour prouver indubitablement l’efficacité d’une telle approche dans le cadre de la prise en charge de la dyslexie, ainsi qu’éventuellement d’autres troubles neuropsychologiques