A Novel Ontology and Machine Learning Driven Hybrid Clinical Decision Support Framework for Cardiovascular Preventative Care

Clinical risk assessment of chronic illnesses is a challenging and complex task which requires the utilisation of standardised clinical practice guidelines and documentation procedures in order to ensure consistent and efficient patient care. Conventional cardiovascular decision support systems have significant limitations, which include the inflexibility to deal with complex clinical processes, hard-wired rigid architectures based on branching logic and the inability to deal with legacy patient data without significant software engineering work. In light of these challenges, we are proposing a novel ontology and machine learning-driven hybrid clinical decision support framework for cardiovascular preventative care. An ontology-inspired approach provides a foundation for information collection, knowledge acquisition and decision support capabilities and aims to develop context sensitive decision support solutions based on ontology engineering principles. The proposed framework incorporates an ontology-driven clinical risk assessment and recommendation system (ODCRARS) and a Machine Learning Driven Prognostic System (MLDPS), integrated as a complete system to provide a cardiovascular preventative care solution. The proposed clinical decision support framework has been developed under the close supervision of clinical domain experts from both UK and US hospitals and is capable of handling multiple cardiovascular diseases. The proposed framework comprises of two novel key components: (1) ODCRARS (2) MLDPS. The ODCRARS is developed under the close supervision of consultant cardiologists Professor Calum MacRae from Harvard Medical School and Professor Stephen Leslie from Raigmore Hospital in Inverness, UK. The ODCRARS comprises of various components, which include: (a) Ontology-driven intelligent context-aware information collection for conducting patient interviews which are driven through a novel clinical questionnaire ontology. (b) A patient semantic profile, is generated using patient medical records which are collated during patient interviews (conducted through an ontology-driven context aware adaptive information collection component). The semantic transformation of patients’ medical data is carried out through a novel patient semantic profile ontology in order to give patient data an intrinsic meaning and alleviate interoperability issues with third party healthcare systems. (c) Ontology driven clinical decision support comprises of a recommendation ontology and a NICE/Expert driven clinical rules engine. The recommendation ontology is developed using clinical rules provided by the consultant cardiologist from the US hospital. The recommendation ontology utilises the patient semantic profile for lab tests and medication recommendation. A clinical rules engine is developed to implement a cardiac risk assessment mechanism for various cardiovascular conditions. The clinical rules engine is also utilised to control the patient flow within the integrated cardiovascular preventative care solution. The machine learning-driven prognostic system is developed in an iterative manner using state of the art feature selection and machine learning techniques. A prognostic model development process is exploited for the development of MLDPS based on clinical case studies in the cardiovascular domain. An additional clinical case study in the breast cancer domain is also carried out for the development and validation purposes. The prognostic model development process is general enough to handle a variety of healthcare datasets which will enable researchers to develop cost effective and evidence based clinical decision support systems. The proposed clinical decision support framework also provides a learning mechanism based on machine learning techniques. Learning mechanism is provided through exchange of patient data amongst the MLDPS and the ODCRARS. The machine learning-driven prognostic system is validated using Raigmore Hospital's RACPC, heart disease and breast cancer clinical case studies

A Framework for Evaluating Model-Driven Self-adaptive Software Systems

In the last few years, Model Driven Development (MDD), Component-based Software Development (CBSD), and context-oriented software have become interesting alternatives for the design and construction of self-adaptive software systems. In general, the ultimate goal of these technologies is to be able to reduce development costs and effort, while improving the modularity, flexibility, adaptability, and reliability of software systems. An analysis of these technologies shows them all to include the principle of the separation of concerns, and their further integration is a key factor to obtaining high-quality and self-adaptable software systems. Each technology identifies different concerns and deals with them separately in order to specify the design of the self-adaptive applications, and, at the same time, support software with adaptability and context-awareness. This research studies the development methodologies that employ the principles of model-driven development in building self-adaptive software systems. To this aim, this article proposes an evaluation framework for analysing and evaluating the features of model-driven approaches and their ability to support software with self-adaptability and dependability in highly dynamic contextual environment. Such evaluation framework can facilitate the software developers on selecting a development methodology that suits their software requirements and reduces the development effort of building self-adaptive software systems. This study highlights the major drawbacks of the propped model-driven approaches in the related works, and emphasise on considering the volatile aspects of self-adaptive software in the analysis, design and implementation phases of the development methodologies. In addition, we argue that the development methodologies should leave the selection of modelling languages and modelling tools to the software developers.Comment: model-driven architecture, COP, AOP, component composition, self-adaptive application, context oriented software developmen

Information and communication technology solutions for outdoor navigation in dementia

INTRODUCTION: Information and communication technology (ICT) is potentially mature enough to empower outdoor and social activities in dementia. However, actual ICT-based devices have limited functionality and impact, mainly limited to safety. What is an ideal operational framework to enhance this field to support outdoor and social activities? METHODS: Review of literature and cross-disciplinary expert discussion. RESULTS: A situation-aware ICT requires a flexible fine-tuning by stakeholders of system usability and complexity of function, and of user safety and autonomy. It should operate by artificial intelligence/machine learning and should reflect harmonized stakeholder values, social context, and user residual cognitive functions. ICT services should be proposed at the prodromal stage of dementia and should be carefully validated within the life space of users in terms of quality of life, social activities, and costs. DISCUSSION: The operational framework has the potential to produce ICT and services with high clinical impact but requires substantial investment

Report from GI-Dagstuhl Seminar 16394: Software Performance Engineering in the DevOps World

This report documents the program and the outcomes of GI-Dagstuhl Seminar 16394 "Software Performance Engineering in the DevOps World". The seminar addressed the problem of performance-aware DevOps. Both, DevOps and performance engineering have been growing trends over the past one to two years, in no small part due to the rise in importance of identifying performance anomalies in the operations (Ops) of cloud and big data systems and feeding these back to the development (Dev). However, so far, the research community has treated software engineering, performance engineering, and cloud computing mostly as individual research areas. We aimed to identify cross-community collaboration, and to set the path for long-lasting collaborations towards performance-aware DevOps. The main goal of the seminar was to bring together young researchers (PhD students in a later stage of their PhD, as well as PostDocs or Junior Professors) in the areas of (i) software engineering, (ii) performance engineering, and (iii) cloud computing and big data to present their current research projects, to exchange experience and expertise, to discuss research challenges, and to develop ideas for future collaborations