Ontology-driven, adaptive, medical questionnaires for patients with mild learning disabilities

Patients with Learning Disabilities (LD) have substantial and unmet healthcare needs, and previous studies have highlighted that they face both health inequalities and worse outcomes than the general population. Primary care practitioners are often the first port-of-call for medical consultations, and one issue faced by LD patients in this context is the very limited time available during consultations - typically less than ten minutes. In order to alleviate this issue, we propose a digital communication aid in the form of an ontology-based medical questionnaire that can adapt to a patient’s medical context as well as their accessibility needs (physical and cognitive). The application is intended to be used in advance of a consultation so that a primary care practitioner may have prior access to their LD patients’ self-reported symptoms. This work builds upon and extends previous research carried out in the development of adaptive medical questionnaires to include interactive and interface functionalities designed specifically to cater for patients with potentially complex accessibility needs. A patient’s current health status and accessibility profile (relating to their impairments) is used to dynamically adjust the structure and content of the medical questionnaire. As such, the system is able to significantly limit and focus questions to immediately relevant concerns while discarding irrelevant questions. We propose that our ontology-based design not only improves the relevance and accessibility of medical questionnaires for patients with LDs, but also provides important benefits in terms of medical knowledge-base modularity, as well as for software extension and maintenance

Evaluating the usability of a tablet application to support adults with mild intellectual disabilities during primary care consultations

Patients with mild intellectual disabilities (ID) face significant communication barriers when attending primary care consultations. Yet there is a lack of two-way communication aids available to support them in conveying medical symptoms to General Practitioners (GPs). Based on a multi-stakeholder co-design process including GPs, domain experts, people with mild ID and carers, our previous work developed prototype technology to support people with mild ID in GP consultations. This paper discusses the findings of a usability study performed on the resulting prototype. Five experts in ID/usability, four caregivers, and five GPs participated in cognitive and post-task walkthroughs. They found that the application has the potential to increase communication, reduce time constraints, and overcome diagnostic overshadowing. Nevertheless, the participants also identified accessibility barriers relating to: medical imagery; the abstract nature of certain conditions; the use of adaptive questionnaires; and the overloading of information. Potential solutions to overcome these barriers were also discussed

Ontology-based personalisation of e-learning resources for disabled students

Students with disabilities are often expected to use e-learning systems to access learning materials but most systems do not provide appropriate adaptation or personalisation to meet their needs.The difficulties related to inadaptability of current learning environments can now be resolved using semantic web technologies such as web ontologies which have been successfully used to drive e-learning personalisation. Nevertheless, e-learning personalisation for students with disabilities has mainly targeted those with single disabilities such as dyslexia or visual impairment, often neglecting those with multiple disabilities due to the difficulty of designing for a combination of disabilities.This thesis argues that it is possible to personalise learning materials for learners with disabilities, including those with multiple disabilities. This is achieved by developing a model that allows the learning environment to present the student with learning materials in suitable formats while considering their disability and learning needs through an ontology-driven and disability-aware personalised e-learning system model (ONTODAPS). A disability ontology known as the Abilities and Disabilities Ontology for Online LEarning and Services (ADOOLES) is developed and used to drive this model. To test the above hypothesis, some case studies are employed to show how the model functions for various individuals with and without disabilities and then the implemented visual interface is experimentally evaluated by eighteen students with disabilities and heuristically by ten lecturers. The results are collected and statistically analysed.The results obtained confirm the above hypothesis and suggest that ONTODAPS can be effectively employed to personalise learning and to manage learning resources. The student participants found that ONTODAPS could aid their learning experience and all agreed that they would like to use this functionality in an existing learning environment. The results also suggest that ONTODAPS provides a platform where students with disabilities can have equivalent learning experience with their peers without disabilities. For the results to be generalised, this study could be extended through further experiments with more diverse groups of students with disabilities and across multiple educational institutions

Design requirements for a digital aid to support adults with mild learning disabilities during clinical consultations: a qualitative study with experts

Background: Adults with mild learning disabilities (MLDs) face a plethora of obstacles when accessing effective health care. Central to many of these barriers is communication, with medical practitioners often remaining untrained on how to interact with patients who have learning disabilities (LDs). To date, research on how to promote this communication has largely centered on the development of low-tech aids. Objective: The objective of this study was to assess the feasibility of utilizing tablet technologies to promote communication between general practitioners and patients with MLDs. We achieved this by identifying a set of design requirements from experts in LDs. Methods: A set of design guidelines was formed during a 2-phase process. Phase 1 involved conducting a series of requirements-gathering interviews with 10 experts in LDs-the protocol of which emerged from the results of a separate scoping review. The interviews were subjected to a framework analysis to discern the key requirements discussed by the experts, and these were embedded within a technology probe. In phase 2, this probe was presented to a subset (n=4) of the experts during a round of usability studies, and the feedback received was used to update the requirements identified in phase 1. Results: An initial set of design requirements has been produced that may assist in the development of clinical Alternative and Augmentative Communication technologies for adults with MLDs. Factors that must be considered range from the health, physical and cognitive needs of stakeholders, to the more individual needs of users. Conclusions: The experts involved in the study were optimistic about the proposed app. They believe that such technologies can help to alleviate time constraints and promote communication by presenting information in a form understood by both practitioners and patients

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

Participative Urban Health and Healthy Aging in the Age of AI

This open access book constitutes the refereed proceedings of the 18th International Conference on String Processing and Information Retrieval, ICOST 2022, held in Paris, France, in June 2022. The 15 full papers and 10 short papers presented in this volume were carefully reviewed and selected from 33 submissions. They cover topics such as design, development, deployment, and evaluation of AI for health, smart urban environments, assistive technologies, chronic disease management, and coaching and health telematics systems

Knowledge engineering with semantic web technologies for decision support systems based on psychological models of expertise

Machines that provide decision support have traditionally used either a representation of human expertise or used mathematical algorithms. Each approach has its own limitations. This study helps to combine both types of decision support system for a single system. However, the focus is on how the machines can formalise and manipulate the human representation of expertise rather than on data processing or machine learning algorithms. It will be based on a system that represents human expertise in a psychological format. The particular decision support system for testing the approach is based on a psychological model of classification that is called the Galatean model of classification. The simple classification problems only require one XML structure to represent each class and the objects to be assigned to it. However, when the classification system is implemented as a decision support system within more complex realworld domains, there may be many variations of the class specification for different types of object to be assigned to the class in different circumstances and by different types of user making the classification decision. All these XML structures will be related to each other in formal ways, based on the original class specification, but managing their relationships and evolution becomes very difficult when the specifications for the XML variants are text-based documents. For dealing with these complexities a knowledge representation needs to be in a format that can be easily understood by human users as well as supporting ongoing knowledge engineering, including evolution and consistency of knowledge. The aim is to explore how semantic web technologies can be employed to help the knowledge engineering process for decision support systems based on human expertise, but deployed in complex domains with variable circumstances. The research evaluated OWL as a suitable vehicle for representing psychological expertise. The task was to see how well it can provide a machine formalism for the knowledge without losing its psychological validity or transparency: that is, the ability of end users to understand the knowledge representation intuitively despite its OWL format. The OWL Galatea model is designed in this study to help in automatic knowledge maintenance, reducing the replication of knowledge with variant uncertainties and support in knowledge engineering processes. The OWL-based approaches used in this model also aid in the adaptive knowledge management. An adaptive assessment questionnaire is an example of it, which is dynamically derived using the users age as the seed for creating the alternative questionnaires. The credibility of the OWL Galatea model is tested by applying it on two extremely different assessment domains (i.e. GRiST and ADVANCE). The conclusions are that OWLbased specifications provide the complementary structures for managing complex knowledge based on human expertise without impeding the end users’ understanding of the knowledgebase. The generic classification model is applicable to many domains and the accompanying OWL specification facilitates its implementations

Conversational affective social robots for ageing and dementia support

Socially assistive robots (SAR) hold significant potential to assist older adults and people with dementia in human engagement and clinical contexts by supporting mental health and independence at home. While SAR research has recently experienced prolific growth, long-term trust, clinical translation and patient benefit remain immature. Affective human-robot interactions are unresolved and the deployment of robots with conversational abilities is fundamental for robustness and humanrobot engagement. In this paper, we review the state of the art within the past two decades, design trends, and current applications of conversational affective SAR for ageing and dementia support. A horizon scanning of AI voice technology for healthcare, including ubiquitous smart speakers, is further introduced to address current gaps inhibiting home use. We discuss the role of user-centred approaches in the design of voice systems, including the capacity to handle communication breakdowns for effective use by target populations. We summarise the state of development in interactions using speech and natural language processing, which forms a baseline for longitudinal health monitoring and cognitive assessment. Drawing from this foundation, we identify open challenges and propose future directions to advance conversational affective social robots for: 1) user engagement, 2) deployment in real-world settings, and 3) clinical translation

The Impact of Digital Technologies on Public Health in Developed and Developing Countries

This open access book constitutes the refereed proceedings of the 18th International Conference on String Processing and Information Retrieval, ICOST 2020, held in Hammamet, Tunisia, in June 2020.* The 17 full papers and 23 short papers presented in this volume were carefully reviewed and selected from 49 submissions. They cover topics such as: IoT and AI solutions for e-health; biomedical and health informatics; behavior and activity monitoring; behavior and activity monitoring; and wellbeing technology. *This conference was held virtually due to the COVID-19 pandemic

Improving Access and Mental Health for Youth Through Virtual Models of Care

The overall objective of this research is to evaluate the use of a mobile health smartphone application (app) to improve the mental health of youth between the ages of 14–25 years, with symptoms of anxiety/depression. This project includes 115 youth who are accessing outpatient mental health services at one of three hospitals and two community agencies. The youth and care providers are using eHealth technology to enhance care. The technology uses mobile questionnaires to help promote self-assessment and track changes to support the plan of care. The technology also allows secure virtual treatment visits that youth can participate in through mobile devices. This longitudinal study uses participatory action research with mixed methods. The majority of participants identified themselves as Caucasian (66.9%). Expectedly, the demographics revealed that Anxiety Disorders and Mood Disorders were highly prevalent within the sample (71.9% and 67.5% respectively). Findings from the qualitative summary established that both staff and youth found the software and platform beneficial