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

Integrative Use of Information Extraction, Semantic Matchmaking and Adaptive Coupling Techniques in Support of Distributed Information Processing and Decision-Making

In order to press maximal cognitive benefit from their social, technological and informational environments, military coalitions need to understand how best to exploit available information assets as well as how best to organize their socially-distributed information processing activities. The International Technology Alliance (ITA) program is beginning to address the challenges associated with enhanced cognition in military coalition environments by integrating a variety of research and development efforts. In particular, research in one component of the ITA ('Project 4: Shared Understanding and Information Exploitation') is seeking to develop capabilities that enable military coalitions to better exploit and distribute networked information assets in the service of collective cognitive outcomes (e.g. improved decision-making). In this paper, we provide an overview of the various research activities in Project 4. We also show how these research activities complement one another in terms of supporting coalition-based collective cognition

US/UK Mental Models of Planning: The Relationship Between Plan Detail and Plan Quality

This paper presents the results of a research study applying a new cultural analysis method to capture commonalities and differences between US and UK mental models of operational planning. The results demonstrate the existence of fundamental differences between the way US and UK planners think about what it means to have a high quality plan. Specifically, the present study captures differences in how US and UK planners conceptualize plan quality. Explicit models of cultural differences in conceptions of plan quality are useful for establishing performance metrics for multinational planning teams. This paper discusses the prospects of enabling automatic evaluation of multinational team performance by combining recent advances in cultural modelling with enhanced ontology languages

Clinical guidelines as plans: An ontological theory

Clinical guidelines are special types of plans realized by collective agents. We provide an ontological theory of such plans that is designed to support the construction of a framework in which guideline-based information systems can be employed in the management of workflow in health care organizations. The framework we propose allows us to represent in formal terms how clinical guidelines are realized through the actions of are realized through the actions of individuals organized into teams. We provide various levels of implementation representing different levels of conformity on the part of health care organizations. Implementations built in conformity with our framework are marked by two dimensions of flexibility that are designed to make them more likely to be accepted by health care professionals than standard guideline-based management systems. They do justice to the fact 1) that responsibilities within a health care organization are widely shared, and 2) that health care professionals may on different occasions be non-compliant with guidelines for a variety of well justified reasons. The advantage of the framework lies in its built-in flexibility, its sensitivity to clinical context, and its ability to use inference tools based on a robust ontology. One disadvantage lies in its complicated implementation

Discovering the Impact of Knowledge in Recommender Systems: A Comparative Study

Recommender systems engage user profiles and appropriate filtering techniques to assist users in finding more relevant information over the large volume of information. User profiles play an important role in the success of recommendation process since they model and represent the actual user needs. However, a comprehensive literature review of recommender systems has demonstrated no concrete study on the role and impact of knowledge in user profiling and filtering approache. In this paper, we review the most prominent recommender systems in the literature and examine the impression of knowledge extracted from different sources. We then come up with this finding that semantic information from the user context has substantial impact on the performance of knowledge based recommender systems. Finally, some new clues for improvement the knowledge-based profiles have been proposed.Comment: 14 pages, 3 tables; International Journal of Computer Science & Engineering Survey (IJCSES) Vol.2, No.3, August 201

Knowledge Management for Public Administrations: Technical Realizations of an Enterprise Attention Management System

The improvement of governments’ efficiency has gained great importance and validity especially in the current times of economic downturn. E-Government constitutes the most contemporary techno-managerial proposition in the track of possible interventions. The paper addresses, more specifically, empowerments necessitated by Public Administration (PA) organizations. Anchored on the needs of three real-life cases, the paper describes the conception and the realization of an IT artefact together with its methodological appeals aiming at improving information access and delivery and thus PAs’ decision making capacity. Our proposition constitutes a novel approach for managing users’ attention in knowledge intensive organizations which goes beyond informing a user about changes in relevant information towards proactively supporting the user to react on changes. The approach is based on an expressive attention model, which is realized by combining ECA (Event-Condition-Action) rules with ontologies. The technical realizations described in the paper constitute the underlying infrastructure of an Enterprise Attention Management System

A flexible architecture for privacy-aware trust management

In service-oriented systems a constellation of services cooperate, sharing potentially sensitive information and responsibilities. Cooperation is only possible if the different participants trust each other. As trust may depend on many different factors, in a flexible framework for Trust Management (TM) trust must be computed by combining different types of information. In this paper we describe the TAS3 TM framework which integrates independent TM systems into a single trust decision point. The TM framework supports intricate combinations whilst still remaining easily extensible. It also provides a unified trust evaluation interface to the (authorization framework of the) services. We demonstrate the flexibility of the approach by integrating three distinct TM paradigms: reputation-based TM, credential-based TM, and Key Performance Indicator TM. Finally, we discuss privacy concerns in TM systems and the directions to be taken for the definition of a privacy-friendly TM architecture.\u