Identification of Consumer Adverse Drug Reaction Messages on Social Media

The prevalence of social media has resulted in spikes of data on the Internet which can have potential use to assist in many aspects of human life. One prospective use of the data is in the development of an early warning system to monitor consumer Adverse Drug Reactions (ADRs). The direct reporting of ADRs by consumers is playing an increasingly important role in the world of pharmacovigilance. Social media provides patients a platform to exchange their experiences regarding the use of certain drugs. However, the messages posted on those social media networks contain both ADR related messages (positive examples) and non-ADR related messages (negative examples). In this paper, we integrate text mining and partially supervised learning methods to automatically extract and classify messages posted on social media networks into positive and negative examples. Our findings can provide managerial insights into how social media analytics can improve not only postmarketing surveillance, but also other problem domains where large quantity of user-generated content is available

Modelo de recuperação e comunicação de conhecimento em emergência médica com utilização de dispositivos portáteis

Tese (doutorado) - Universidade Federal de Santa Catarina, Centro Tecnológico, Programa de Pós-graduação em Engenharia e Gestão do Conhecimento, Florianópolis, 2009A evolução da tecnologia de computação móvel e a crescente informatização em ambientes hospitalares viabilizam o uso de dispositivos portáteis para apoiar as atividades de profissionais que atuam em emergência médica. O ambiente de emergência é caracterizado pela mobilidade e atendimentos que podem ocorrer em situações bastante adversas como tumultos, locais de risco, mau tempo e com recursos escassos. Todos os pacientes, que se encontram em situação risco, devem ser atendidos e tratados da mesma maneira, seguindo os padrões de atendimento determinados pelas organizações de saúde. Adicionalmente, limitações tecnológicas podem dificultar a comunicação e o acesso à informação para tomada de decisão clínica. O processo de assistência médica emergencial é intensivo em conhecimento. Parte deste conhecimento é declarado quando especialistas executam consultas em bases de conhecimento, utilizando seus dispositivos portáteis. Capturar conhecimento neste ambiente complexo sem introduzir alterações na rotina de atendimento é um desafio. Esta pesquisa tem como objetivo principal apresentar um modelo diferenciado de recuperação de documentos para apoiar a decisão clínica com a utilização de dispositivos móveis. Desta forma, qualquer terminologia informal no domínio é extraída sem interferir no fluxo de trabalho dos profissionais em urgências e emergências médicas. O modelo proposto contribui com o desenvolvimento de terminologia para indexação e recuperação da informação em bases de conhecimento. Um cache baseado na semântica das consultas é proposto para auxiliar na extração de conhecimento e tratar limitações tecnológicas. Para testar a viabilidade do modelo proposto, foi desenvolvido um protótipo que foi projetado para funcionamento em um dispositivo portátil. Simulações de estudos de casos, utilizando o protótipo, indicam que o objetivo foi alcançado com sucesso. Adicionalmente, observaram-se contribuições interessantes para aplicações em ambiente de emergência médica como a redução do tempo de resposta de consultas, do consumo de bateria e o aumento da disponibilidade de informação em momentos de desconexão

Information technologies for pain management

Millions of people around the world suffer from pain, acute or chronic and this raises the importance of its screening, assessment and treatment. The importance of pain is attested by the fact that it is considered the fifth vital sign for indicating basic bodily functions, health and quality of life, together with the four other vital signs: blood pressure, body temperature, pulse rate and respiratory rate. However, while these four signals represent an objective physical parameter, the occurrence of pain expresses an emotional status that happens inside the mind of each individual and therefore, is highly subjective that makes difficult its management and evaluation. For this reason, the self-report of pain is considered the most accurate pain assessment method wherein patients should be asked to periodically rate their pain severity and related symptoms. Thus, in the last years computerised systems based on mobile and web technologies are becoming increasingly used to enable patients to report their pain which lead to the development of electronic pain diaries (ED). This approach may provide to health care professionals (HCP) and patients the ability to interact with the system anywhere and at anytime thoroughly changes the coordinates of time and place and offers invaluable opportunities to the healthcare delivery. However, most of these systems were designed to interact directly to patients without presence of a healthcare professional or without evidence of reliability and accuracy. In fact, the observation of the existing systems revealed lack of integration with mobile devices, limited use of web-based interfaces and reduced interaction with patients in terms of obtaining and viewing information. In addition, the reliability and accuracy of computerised systems for pain management are rarely proved or their effects on HCP and patients outcomes remain understudied. This thesis is focused on technology for pain management and aims to propose a monitoring system which includes ubiquitous interfaces specifically oriented to either patients or HCP using mobile devices and Internet so as to allow decisions based on the knowledge obtained from the analysis of the collected data. With the interoperability and cloud computing technologies in mind this system uses web services (WS) to manage data which are stored in a Personal Health Record (PHR). A Randomised Controlled Trial (RCT) was implemented so as to determine the effectiveness of the proposed computerised monitoring system. The six weeks RCT evidenced the advantages provided by the ubiquitous access to HCP and patients so as to they were able to interact with the system anywhere and at anytime using WS to send and receive data. In addition, the collected data were stored in a PHR which offers integrity and security as well as permanent on line accessibility to both patients and HCP. The study evidenced not only that the majority of participants recommend the system, but also that they recognize it suitability for pain management without the requirement of advanced skills or experienced users. Furthermore, the system enabled the definition and management of patient-oriented treatments with reduced therapist time. The study also revealed that the guidance of HCP at the beginning of the monitoring is crucial to patients' satisfaction and experience stemming from the usage of the system as evidenced by the high correlation between the recommendation of the application, and it suitability to improve pain management and to provide medical information. There were no significant differences regarding to improvements in the quality of pain treatment between intervention group and control group. Based on the data collected during the RCT a clinical decision support system (CDSS) was developed so as to offer capabilities of tailored alarms, reports, and clinical guidance. This CDSS, called Patient Oriented Method of Pain Evaluation System (POMPES), is based on the combination of several statistical models (one-way ANOVA, Kruskal-Wallis and Tukey-Kramer) with an imputation model based on linear regression. This system resulted in fully accuracy related to decisions suggested by the system compared with the medical diagnosis, and therefore, revealed it suitability to manage the pain. At last, based on the aerospace systems capability to deal with different complex data sources with varied complexities and accuracies, an innovative model was proposed. This model is characterized by a qualitative analysis stemming from the data fusion method combined with a quantitative model based on the comparison of the standard deviation together with the values of mathematical expectations. This model aimed to compare the effects of technological and pen-and-paper systems when applied to different dimension of pain, such as: pain intensity, anxiety, catastrophizing, depression, disability and interference. It was observed that pen-and-paper and technology produced equivalent effects in anxiety, depression, interference and pain intensity. On the contrary, technology evidenced favourable effects in terms of catastrophizing and disability. The proposed method revealed to be suitable, intelligible, easy to implement and low time and resources consuming. Further work is needed to evaluate the proposed system to follow up participants for longer periods of time which includes a complementary RCT encompassing patients with chronic pain symptoms. Finally, additional studies should be addressed to determine the economic effects not only to patients but also to the healthcare system