Integration of Temporal Abstraction and Dynamic Bayesian Networks in Clinical Systems. A preliminary approach

Abstraction of temporal data (TA) aims to abstract time-points into higher-level interval concepts and to detect significant trends in both low-level data and abstract concepts. TA methods are used for summarizing and interpreting clinical data. Dynamic Bayesian Networks (DBNs) are temporal probabilistic graphical models which can be used to represent knowledge about uncertain temporal relationships between events and state changes during time. In clinical systems, they were introduced to encode and use the domain knowledge acquired from human experts to perform decision support. A hypothesis that this study plans to investigate is whether temporal abstraction methods can be effectively integrated with DBNs in the context of medical decision-support systems. A preliminary approach is presented where a DBN model is constructed for prognosis of the risk for coronary artery disease (CAD) based on its risk factors and using as test bed a dataset that was collected after monitoring patients who had positive history of cardiovascular disease. The technical objectives of this study are to examine how DBNs will represent the abstracted data in order to construct the prognostic model and whether the retrieved rules from the model can be used for generating more complex abstractions

Advances in computational modelling for personalised medicine after myocardial infarction

Myocardial infarction (MI) is a leading cause of premature morbidity and mortality worldwide. Determining which patients will experience heart failure and sudden cardiac death after an acute MI is notoriously difficult for clinicians. The extent of heart damage after an acute MI is informed by cardiac imaging, typically using echocardiography or sometimes, cardiac magnetic resonance (CMR). These scans provide complex data sets that are only partially exploited by clinicians in daily practice, implying potential for improved risk assessment. Computational modelling of left ventricular (LV) function can bridge the gap towards personalised medicine using cardiac imaging in patients with post-MI. Several novel biomechanical parameters have theoretical prognostic value and may be useful to reflect the biomechanical effects of novel preventive therapy for adverse remodelling post-MI. These parameters include myocardial contractility (regional and global), stiffness and stress. Further, the parameters can be delineated spatially to correspond with infarct pathology and the remote zone. While these parameters hold promise, there are challenges for translating MI modelling into clinical practice, including model uncertainty, validation and verification, as well as time-efficient processing. More research is needed to (1) simplify imaging with CMR in patients with post-MI, while preserving diagnostic accuracy and patient tolerance (2) to assess and validate novel biomechanical parameters against established prognostic biomarkers, such as LV ejection fraction and infarct size. Accessible software packages with minimal user interaction are also needed. Translating benefits to patients will be achieved through a multidisciplinary approach including clinicians, mathematicians, statisticians and industry partners

Automatic production and integration of knowledge to the support of the decision and planning activities in medical-clinical diagnosis, treatment and prognosis.

El concepto de procedimiento médico se refiere al conjunto de actividades seguidas por los profesionales de la salud para solucionar o mitigar el problema de salud que afecta a un paciente. La toma de decisiones dentro del procedimiento médico ha sido, por largo tiempo, uno de las áreas más interesantes de investigación en la informática médica y el contexto de investigación de esta tesis. La motivación para desarrollar este trabajo de investigación se basa en tres aspectos fundamentales: no hay modelos de conocimiento para todas las actividades médico-clínicas que puedan ser inducidas a partir de datos médicos, no hay soluciones de aprendizaje inductivo para todas las actividades de la asistencia médica y no hay un modelo integral que formalice el concepto de procedimiento médico. Por tanto, nuestro objetivo principal es desarrollar un modelo computable basado en conocimiento que integre todas las actividades de decisión y planificación para el diagnóstico, tratamiento y pronóstico médico-clínicos. Para alcanzar el objetivo principal, en primer lugar, explicamos el problema de investigación. En segundo lugar, describimos los antecedentes del problema de investigación desde los contextos médico e informático. En tercer lugar, explicamos el desarrollo de la propuesta de investigación, basada en cuatro contribuciones principales: un nuevo modelo, basado en datos y conocimiento, para la actividad de planificación en el diagnóstico y tratamiento médico-clínicos; una novedosa metodología de aprendizaje inductivo para la actividad de planificación en el diagnóstico y tratamiento médico-clínico; una novedosa metodología de aprendizaje inductivo para la actividad de decisión en el pronóstico médico-clínico, y finalmente, un nuevo modelo computable, basado en datos y conocimiento, que integra las actividades de decisión y planificación para el diagnóstico, tratamiento y pronóstico médico-clínicos.The concept of medical procedure refers to the set of activities carried out by the health care professionals to solve or mitigate the health problems that affect a patient. Decisions making within a medical procedure has been, for a long time, one of the most interesting research areas in medical informatics and the research context of this thesis. The motivation to develop this research work is based on three main aspects: Nowadays there are not knowledge models for all the medical-clinical activities that can be induced from medical data, there are not inductive learning solutions for all the medical-clinical activities, and there is not an integral model that formalizes the concept of medical procedure. Therefore, our main objective is to develop a computable model based in knowledge that integrates all the decision and planning activities for the medical-clinical diagnosis, treatment and prognosis. To achieve this main objective: first, we explain the research problem. Second, we describe the background of the work from both the medical and the informatics contexts. Third, we explain the development of the research proposal based on four main contributions: a novel knowledge representation model, based in data, to the planning activity in medical-clinical diagnosis and treatment; a novel inductive learning methodology to the planning activity in diagnosis and medical-clinical treatment; a novel inductive learning methodology to the decision activity in medical-clinical prognosis, and finally, a novel computable model, based on data and knowledge, which integrates the decision and planning activities of medical-clinical diagnosis, treatment and prognosis

Big data analytics for preventive medicine

© 2019, Springer-Verlag London Ltd., part of Springer Nature. Medical data is one of the most rewarding and yet most complicated data to analyze. How can healthcare providers use modern data analytics tools and technologies to analyze and create value from complex data? Data analytics, with its promise to efficiently discover valuable pattern by analyzing large amount of unstructured, heterogeneous, non-standard and incomplete healthcare data. It does not only forecast but also helps in decision making and is increasingly noticed as breakthrough in ongoing advancement with the goal is to improve the quality of patient care and reduces the healthcare cost. The aim of this study is to provide a comprehensive and structured overview of extensive research on the advancement of data analytics methods for disease prevention. This review first introduces disease prevention and its challenges followed by traditional prevention methodologies. We summarize state-of-the-art data analytics algorithms used for classification of disease, clustering (unusually high incidence of a particular disease), anomalies detection (detection of disease) and association as well as their respective advantages, drawbacks and guidelines for selection of specific model followed by discussion on recent development and successful application of disease prevention methods. The article concludes with open research challenges and recommendations

Significant Feature Selection Method for Health Domain using Computational Intelligence- A Case Study for Heart Disease

In the medical field, the diagnosing of cardiovascular disease is that the most troublesome task. The diagnosis of heart disease is difficult as a decision relied on grouping of large clinical and pathological data. Due to this complication, the interest increased in a very vital quantity between the researchers and clinical professionals regarding the economical and correct heart disease prediction. In case of heart disease, the correct diagnosis in early stage is important as time is the very important factor. Heart disease is the principal supply of deaths widespread, and the prediction of Heart Disease is significant at an untimely phase. Machine learning in recent years has been the evolving, reliable and supporting tools in medical domain and has provided the best support for predicting disease with correct case of training and testing. The main idea behind this work is to find relevant heart disease feature among the large number of feature using rough computational Intelligence approach. The proposed feature selection approach performance is better than traditional feature selection approaches. The performances of the rough computation approach is tested with different heart disease data sets and validated with real-time data sets

Doctor of Philosophy

dissertationTemporal reasoning denotes the modeling of causal relationships between different variables across different instances of time, and the prediction of future events or the explanation of past events. Temporal reasoning helps in modeling and understanding interactions between human pathophysiological processes, and in predicting future outcomes such as response to treatment or complications. Dynamic Bayesian Networks (DBN) support modeling changes in patients' condition over time due to both diseases and treatments, using probabilistic relationships between different clinical variables, both within and across different points in time. We describe temporal reasoning and representation in general and DBN in particular, with special attention to DBN parameter learning and inference. We also describe temporal data preparation (aggregation, consolidation, and abstraction) techniques that are applicable to medical data that were used in our research. We describe and evaluate various data discretization methods that are applicable to medical data. Projeny, an opensource probabilistic temporal reasoning toolkit developed as part of this research, is also described. We apply these methods, techniques, and algorithms to two disease processes modeled as Dynamic Bayesian Networks. The first test case is hyperglycemia due to severe illness in patients treated in the Intensive Care Unit (ICU). We model the patients' serum glucose and insulin drip rates using Dynamic Bayesian Networks, and recommend insulin drip rates to maintain the patients' serum glucose within a normal range. The model's safety and efficacy are proven by comparing it to the current gold standard. The second test case is the early prediction of sepsis in the emergency department. Sepsis is an acute life threatening condition that requires timely diagnosis and treatment. We present various DBN models and data preparation techniques that detect sepsis with very high accuracy within two hours after the patients' admission to the emergency department. We also discuss factors affecting the computational tractability of the models and appropriate optimization techniques. In this dissertation, we present a guide to temporal reasoning, evaluation of various data preparation, discretization, learning and inference methods, proofs using two test cases using real clinical data, an open-source toolkit, and recommend methods and techniques for temporal reasoning in medicine

Decision fusion in healthcare and medicine : a narrative review

Objective: To provide an overview of the decision fusion (DF) technique and describe the applications of the technique in healthcare and medicine at prevention, diagnosis, treatment and administrative levels. Background: The rapid development of technology over the past 20 years has led to an explosion in data growth in various industries, like healthcare. Big data analysis within the healthcare systems is essential for arriving to a value-based decision over a period of time. Diversity and uncertainty in big data analytics have made it impossible to analyze data by using conventional data mining techniques and thus alternative solutions are required. DF is a form of data fusion techniques that could increase the accuracy of diagnosis and facilitate interpretation, summarization and sharing of information. Methods: We conducted a review of articles published between January 1980 and December 2020 from various databases such as Google Scholar, IEEE, PubMed, Science Direct, Scopus and web of science using the keywords decision fusion (DF), information fusion, healthcare, medicine and big data. A total of 141 articles were included in this narrative review. Conclusions: Given the importance of big data analysis in reducing costs and improving the quality of healthcare; along with the potential role of DF in big data analysis, it is recommended to know the full potential of this technique including the advantages, challenges and applications of the technique before its use. Future studies should focus on describing the methodology and types of data used for its applications within the healthcare sector

A Comprehensive Scoping Review of Bayesian Networks in Healthcare: Past, Present and Future

No comprehensive review of Bayesian networks (BNs) in healthcare has been published in the past, making it difficult to organize the research contributions in the present and identify challenges and neglected areas that need to be addressed in the future. This unique and novel scoping review of BNs in healthcare provides an analytical framework for comprehensively characterizing the domain and its current state. The review shows that: (1) BNs in healthcare are not used to their full potential; (2) a generic BN development process is lacking; (3) limitations exists in the way BNs in healthcare are presented in the literature, which impacts understanding, consensus towards systematic methodologies, practice and adoption of BNs; and (4) a gap exists between having an accurate BN and a useful BN that impacts clinical practice. This review empowers researchers and clinicians with an analytical framework and findings that will enable understanding of the need to address the problems of restricted aims of BNs, ad hoc BN development methods, and the lack of BN adoption in practice. To map the way forward, the paper proposes future research directions and makes recommendations regarding BN development methods and adoption in practice