User-centered visual analysis using a hybrid reasoning architecture for intensive care units

One problem pertaining to Intensive Care Unit information systems is that, in some cases, a very dense display of data can result. To ensure the overview and readability of the increasing volumes of data, some special features are required (e.g., data prioritization, clustering, and selection mechanisms) with the application of analytical methods (e.g., temporal data abstraction, principal component analysis, and detection of events). This paper addresses the problem of improving the integration of the visual and analytical methods applied to medical monitoring systems. We present a knowledge- and machine learning-based approach to support the knowledge discovery process with appropriate analytical and visual methods. Its potential benefit to the development of user interfaces for intelligent monitors that can assist with the detection and explanation of new, potentially threatening medical events. The proposed hybrid reasoning architecture provides an interactive graphical user interface to adjust the parameters of the analytical methods based on the users' task at hand. The action sequences performed on the graphical user interface by the user are consolidated in a dynamic knowledge base with specific hybrid reasoning that integrates symbolic and connectionist approaches. These sequences of expert knowledge acquisition can be very efficient for making easier knowledge emergence during a similar experience and positively impact the monitoring of critical situations. The provided graphical user interface incorporating a user-centered visual analysis is exploited to facilitate the natural and effective representation of clinical information for patient care

Doctor of Philosophy

dissertationA broad range of applications capture dynamic data at an unprecedented scale. Independent of the application area, finding intuitive ways to understand the dynamic aspects of these increasingly large data sets remains an interesting and, to some extent, unsolved research problem. Generically, dynamic data sets can be described by some, often hierarchical, notion of feature of interest that exists at each moment in time, and those features evolve across time. Consequently, exploring the evolution of these features is considered to be one natural way of studying these data sets. Usually, this process entails the ability to: 1) define and extract features from each time step in the data set; 2) find their correspondences over time; and 3) analyze their evolution across time. However, due to the large data sizes, visualizing the evolution of features in a comprehensible manner and performing interactive changes are challenging. Furthermore, feature evolution details are often unmanageably large and complex, making it difficult to identify the temporal trends in the underlying data. Additionally, many existing approaches develop these components in a specialized and standalone manner, thus failing to address the general task of understanding feature evolution across time. This dissertation demonstrates that interactive exploration of feature evolution can be achieved in a non-domain-specific manner so that it can be applied across a wide variety of application domains. In particular, a novel generic visualization and analysis environment that couples a multiresolution unified spatiotemporal representation of features with progressive layout and visualization strategies for studying the feature evolution across time is introduced. This flexible framework enables on-the-fly changes to feature definitions, their correspondences, and other arbitrary attributes while providing an interactive view of the resulting feature evolution details. Furthermore, to reduce the visual complexity within the feature evolution details, several subselection-based and localized, per-feature parameter value-based strategies are also enabled. The utility and generality of this framework is demonstrated by using several large-scale dynamic data sets

Visualisation of Integrated Patient-Centric Data as Pathways: Enhancing Electronic Medical Records in Clinical Practice

Routinely collected data in hospital Electronic Medical Records (EMR) is rich and abundant but often not linked or analysed for purposes other than direct patient care. We have created a methodology to integrate patient-centric data from different EMR systems into clinical pathways that represent the history of all patient interactions with the hospital during the course of a disease and beyond. In this paper, the literature in the area of data visualisation in healthcare is reviewed and a method for visualising the journeys that patients take through care is discussed. Examples of the hidden knowledge that could be discovered using this approach are explored and the main application areas of visualisation tools are identified. This paper also highlights the challenges of collecting and analysing such data and making the visualisations extensively used in the medical domain. This paper starts by presenting the state-of-the-art in visualisation of clinical and other health related data. Then, it describes an example clinical problem and discusses the visualisation tools and techniques created for the utilisation of these data by clinicians and researchers. Finally, we look at the open problems in this area of research and discuss future challenges

Clinflow:an interactive application for processing and exploring clinical data

Abstract. Clinical data is the most valuable resource in healthcare development, but it also comes with many challenges. When clinical researchers are required to combine medical expertise with statistical and programming knowledge, the need for data analysis tools arises. The aim of this thesis was to design ClinFlow, an application for clinical data processing and visualization based on user needs. R language and Shiny framework were selected for creating this tool. The goal was to give the means for the clinical researcher to conduct data analysis in an interactive environment, with no need for statistical programming knowledge. A case study using data from The Finnish Type 1 Diabetes Prediction and Prevention (DIPP) study was conducted to demonstrate the feasibility of this application. The initial results achieved in this case study support the previous research of the DIPP study. ClinFlow shows potential for becoming a useful data analysis tool for clinical research

Scaling Up Medical Visualization : Multi-Modal, Multi-Patient, and Multi-Audience Approaches for Medical Data Exploration, Analysis and Communication

Medisinsk visualisering er en av de mest applikasjonsrettede områdene av visualiseringsforsking. Tett samarbeid med medisinske eksperter er nødvendig for å tolke medisinsk bildedata og lage betydningsfulle visualiseringsteknikker og visualiseringsapplikasjoner. Kreft er en av de vanligste dødsårsakene, og med økende gjennomsnittsalder i i-land øker også antallet diagnoser av gynekologisk kreft. Moderne avbildningsteknikker er et viktig verktøy for å vurdere svulster og produsere et økende antall bildedata som radiologer må tolke. I tillegg til antallet bildemodaliteter, øker også antallet pasienter, noe som fører til at visualiseringsløsninger må bli skalert opp for å adressere den økende kompleksiteten av multimodal- og multipasientdata. Dessuten er ikke medisinsk visualisering kun tiltenkt medisinsk personale, men har også som mål å informere pasienter, pårørende, og offentligheten om risikoen relatert til visse sykdommer, og mulige behandlinger. Derfor har vi identifisert behovet for å skalere opp medisinske visualiseringsløsninger for å kunne håndtere multipublikumdata. Denne avhandlingen adresserer skaleringen av disse dimensjonene i forskjellige bidrag vi har kommet med. Først presenterer vi teknikkene våre for å skalere visualiseringer i flere modaliteter. Vi introduserer en visualiseringsteknikk som tar i bruk små multipler for å vise data fra flere modaliteter innenfor et bildesnitt. Dette lar radiologer utforske dataen effektivt uten å måtte bruke flere sidestilte vinduer. I det neste steget utviklet vi en analyseplatform ved å ta i bruk «radiomic tumor profiling» på forskjellige bildemodaliteter for å analysere kohortdata og finne nye biomarkører fra bilder. Biomarkører fra bilder er indikatorer basert på bildedata som kan forutsi variabler relatert til kliniske utfall. «Radiomic tumor profiling» er en teknikk som genererer mulige biomarkører fra bilder basert på første- og andregrads statistiske målinger. Applikasjonen lar medisinske eksperter analysere multiparametrisk bildedata for å finne mulige korrelasjoner mellom kliniske parameter og data fra «radiomic tumor profiling». Denne tilnærmingen skalerer i to dimensjoner, multimodal og multipasient. I en senere versjon la vi til funksjonalitet for å skalere multipublikumdimensjonen ved å gjøre applikasjonen vår anvendelig for livmorhalskreft- og prostatakreftdata, i tillegg til livmorkreftdataen som applikasjonen var designet for. I et senere bidrag fokuserer vi på svulstdata på en annen skala og muliggjør analysen av svulstdeler ved å bruke multimodal bildedata i en tilnærming basert på hierarkisk gruppering. Applikasjonen vår finner mulige interessante regioner som kan informere fremtidige behandlingsavgjørelser. I et annet bidrag, en digital sonderingsinteraksjon, fokuserer vi på multipasientdata. Bildedata fra flere pasienter kan sammenlignes for å finne interessante mønster i svulstene som kan være knyttet til hvor aggressive svulstene er. Til slutt skalerer vi multipublikumdimensjonen med en likhetsvisualisering som er anvendelig for forskning på livmorkreft, på bilder av nevrologisk kreft, og maskinlæringsforskning på automatisk segmentering av svulstdata. Som en kontrast til de allerede fremhevete bidragene, fokuserer vårt siste bidrag, ScrollyVis, hovedsakelig på multipublikumkommunikasjon. Vi muliggjør skapelsen av dynamiske og vitenskapelige “scrollytelling”-opplevelser for spesifikke eller generelle publikum. Slike historien kan bli brukt i spesifikke brukstilfeller som kommunikasjon mellom lege og pasient, eller for å kommunisere vitenskapelige resultater via historier til et generelt publikum i en digital museumsutstilling. Våre foreslåtte applikasjoner og interaksjonsteknikker har blitt demonstrert i brukstilfeller og evaluert med domeneeksperter og fokusgrupper. Dette har ført til at noen av våre bidrag allerede er i bruk på andre forskingsinstitusjoner. Vi ønsker å evaluere innvirkningen deres på andre vitenskapelige felt og offentligheten i fremtidige arbeid.Medical visualization is one of the most application-oriented areas of visualization research. Close collaboration with medical experts is essential for interpreting medical imaging data and creating meaningful visualization techniques and visualization applications. Cancer is one of the most common causes of death, and with increasing average age in developed countries, gynecological malignancy case numbers are rising. Modern imaging techniques are an essential tool in assessing tumors and produce an increasing number of imaging data radiologists must interpret. Besides the number of imaging modalities, the number of patients is also rising, leading to visualization solutions that must be scaled up to address the rising complexity of multi-modal and multi-patient data. Furthermore, medical visualization is not only targeted toward medical professionals but also has the goal of informing patients, relatives, and the public about the risks of certain diseases and potential treatments. Therefore, we identify the need to scale medical visualization solutions to cope with multi-audience data. This thesis addresses the scaling of these dimensions in different contributions we made. First, we present our techniques to scale medical visualizations in multiple modalities. We introduced a visualization technique using small multiples to display the data of multiple modalities within one imaging slice. This allows radiologists to explore the data efficiently without having several juxtaposed windows. In the next step, we developed an analysis platform using radiomic tumor profiling on multiple imaging modalities to analyze cohort data and to find new imaging biomarkers. Imaging biomarkers are indicators based on imaging data that predict clinical outcome related variables. Radiomic tumor profiling is a technique that generates potential imaging biomarkers based on first and second-order statistical measurements. The application allows medical experts to analyze the multi-parametric imaging data to find potential correlations between clinical parameters and the radiomic tumor profiling data. This approach scales up in two dimensions, multi-modal and multi-patient. In a later version, we added features to scale the multi-audience dimension by making our application applicable to cervical and prostate cancer data and the endometrial cancer data the application was designed for. In a subsequent contribution, we focus on tumor data on another scale and enable the analysis of tumor sub-parts by using the multi-modal imaging data in a hierarchical clustering approach. Our application finds potentially interesting regions that could inform future treatment decisions. In another contribution, the digital probing interaction, we focus on multi-patient data. The imaging data of multiple patients can be compared to find interesting tumor patterns potentially linked to the aggressiveness of the tumors. Lastly, we scale the multi-audience dimension with our similarity visualization applicable to endometrial cancer research, neurological cancer imaging research, and machine learning research on the automatic segmentation of tumor data. In contrast to the previously highlighted contributions, our last contribution, ScrollyVis, focuses primarily on multi-audience communication. We enable the creation of dynamic scientific scrollytelling experiences for a specific or general audience. Such stories can be used for specific use cases such as patient-doctor communication or communicating scientific results via stories targeting the general audience in a digital museum exhibition. Our proposed applications and interaction techniques have been demonstrated in application use cases and evaluated with domain experts and focus groups. As a result, we brought some of our contributions to usage in practice at other research institutes. We want to evaluate their impact on other scientific fields and the general public in future work.Doktorgradsavhandlin