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

A framework for decision making on teleexpertise with traceability of the reasoning

This paper provides a methodological framework for decision making process to ensure its traceability generally in the context of telemedicine and particularly in the act of teleexpertise. This act permits to medical professionals and/or health professionals to collaborate in order to take suitable decisions for a patient diagnosis or treatment. The main problem dealing with teleexpertise is the following: How to ensure the traceability of the decisions making process? This problem is solved in this paper through a conceptualisation of a rigorous framework coupling semantic modelling and explicit reasoning which permits to fully support the analysis and rationale for decisions made. The logical semantic underlying this framework is the argumentative logicto provide adequate management of information with traceability of the reasoning including options and constraints. Thus our proposal will permit to formally ensure the traceability of reasoning in telemedicine and particularly in teleexpertise in order to favour the quality of telemedicine’s procedure checking. This traceability is to guarantee equitable access to the benefits of the collective knowledge and experience and to provide remote collaborative practices with a sufficient safety margin to guard against the legal requirements. An illustrative case study is provided by the modelling of a decision making process applied to teleexpertise for chronic diseases such as diabetes mellitus type2

Verifying a medical protocol with temporal graphs: The case of a nosocomial disease

Objective: Our contribution focuses on the implementation of a formal verification approach for medical protocols with graphical temporal reasoning paths to facilitate the understanding of verification steps. Materials and methods: Formal medical guideline specifications and background knowledge are represented through conceptual graphs, and reasoning is based on graph homomorphism. These materials explain the underlying principles or rationale that guide the functioning of verifications. Results: An illustration of this proposal is made using a medical protocol defining guidelines for the monitoring and prevention of nosocomial infections. Such infections, which are acquired in the hospital, increasemorbidity andmortality and add noticeably to economic burden. An evaluation of the use of the graphical verification found that this method aids in the improvement of both clinical knowledge and the quality of actions made. Discussion: As conceptual graphs, representations based on diagrams can be translated into computational tree logic. However, diagrams are much more natural and explicitly human, emphasizing a theoretical and practical consistency. Conclusion: The proposed approach allows for the visualmodeling of temporal reasoning and a formalization of knowledge that can assist in the diagnosis and treatment of nosocomial infections and some clinical problems. This is the first time that one emphasizes the temporal situation modeling in conceptual graphs. It will also deliver a formal verification method for clinical guideline analyses

Conceptual graph-based knowledge representation for supporting reasoning in African traditional medicine

Although African patients use both conventional or modern and traditional healthcare simultaneously, it has been proven that 80% of people rely on African traditional medicine (ATM). ATM includes medical activities stemming from practices, customs and traditions which were integral to the distinctive African cultures. It is based mainly on the oral transfer of knowledge, with the risk of losing critical knowledge. Moreover, practices differ according to the regions and the availability of medicinal plants. Therefore, it is necessary to compile tacit, disseminated and complex knowledge from various Tradi-Practitioners (TP) in order to determine interesting patterns for treating a given disease. Knowledge engineering methods for traditional medicine are useful to model suitably complex information needs, formalize knowledge of domain experts and highlight the effective practices for their integration to conventional medicine. The work described in this paper presents an approach which addresses two issues. First it aims at proposing a formal representation model of ATM knowledge and practices to facilitate their sharing and reusing. Then, it aims at providing a visual reasoning mechanism for selecting best available procedures and medicinal plants to treat diseases. The approach is based on the use of the Delphi method for capturing knowledge from various experts which necessitate reaching a consensus. Conceptual graph formalism is used to model ATM knowledge with visual reasoning capabilities and processes. The nested conceptual graphs are used to visually express the semantic meaning of Computational Tree Logic (CTL) constructs that are useful for formal specification of temporal properties of ATM domain knowledge. Our approach presents the advantage of mitigating knowledge loss with conceptual development assistance to improve the quality of ATM care (medical diagnosis and therapeutics), but also patient safety (drug monitoring)

Combining conceptual graphs and argumentation for aiding in the teleexpertise

Current medical information systems are too complex to be meaningfully exploited. Hence there is a need to develop new strategies for maximising the exploitation of medical data to the benefit of medical professionals. It is against this backdrop that we want to propose a tangible contribution by providing a tool which combines conceptual graphs and Dung׳s argumentation system in order to assist medical professionals in their decision making process. The proposed tool allows medical professionals to easily manipulate and visualise queries and answers for making decisions during the practice of teleexpertise. The knowledge modelling is made using an open application programming interface (API) called CoGui, which offers the means for building structured knowledge bases with the dedicated functionalities of graph-based reasoning via retrieved data from different institutions (hospitals, national security centre, and nursing homes). The tool that we have described in this study supports a formal traceable structure of the reasoning with acceptable arguments to elucidate some ethical problems that occur very often in the telemedicine domain

Working Notes from the 1992 AAAI Workshop on Automating Software Design. Theme: Domain Specific Software Design

The goal of this workshop is to identify different architectural approaches to building domain-specific software design systems and to explore issues unique to domain-specific (vs. general-purpose) software design. Some general issues that cut across the particular software design domain include: (1) knowledge representation, acquisition, and maintenance; (2) specialized software design techniques; and (3) user interaction and user interface

Factors shaping the evolution of electronic documentation systems

The main goal is to prepare the space station technical and managerial structure for likely changes in the creation, capture, transfer, and utilization of knowledge. By anticipating advances, the design of Space Station Project (SSP) information systems can be tailored to facilitate a progression of increasingly sophisticated strategies as the space station evolves. Future generations of advanced information systems will use increases in power to deliver environmentally meaningful, contextually targeted, interconnected data (knowledge). The concept of a Knowledge Base Management System is emerging when the problem is focused on how information systems can perform such a conversion of raw data. Such a system would include traditional management functions for large space databases. Added artificial intelligence features might encompass co-existing knowledge representation schemes; effective control structures for deductive, plausible, and inductive reasoning; means for knowledge acquisition, refinement, and validation; explanation facilities; and dynamic human intervention. The major areas covered include: alternative knowledge representation approaches; advanced user interface capabilities; computer-supported cooperative work; the evolution of information system hardware; standardization, compatibility, and connectivity; and organizational impacts of information intensive environments

Information Systems and Healthcare XXXIV: Clinical Knowledge Management Systems—Literature Review and Research Issues for Information Systems

Knowledge Management (KM) has emerged as a possible solution to many of the challenges facing U.S. and international healthcare systems. These challenges include concerns regarding the safety and quality of patient care, critical inefficiency, disparate technologies and information standards, rapidly rising costs and clinical information overload. In this paper, we focus on clinical knowledge management systems (CKMS) research. The objectives of the paper are to evaluate the current state of knowledge management systems diffusion in the clinical setting, assess the present status and focus of CKMS research efforts, and identify research gaps and opportunities for future work across the medical informatics and information systems disciplines. The study analyzes the literature along two dimensions: (1) the knowledge management processes of creation, capture, transfer, and application, and (2) the clinical processes of diagnosis, treatment, monitoring and prognosis. The study reveals that the vast majority of CKMS research has been conducted by the medical and health informatics communities. Information systems (IS) researchers have played a limited role in past CKMS research. Overall, the results indicate that there is considerable potential for IS researchers to contribute their expertise to the improvement of clinical process through technology-based KM approaches