Bayesian Networks for Clinical Decision Making : Support, Assurance, Trust

PhD thesisBayesian networks have been widely proposed to assist clinical decision making. Their popularity is due to their ability to combine different sources of information and reason under uncertainty, using sound probabilistic laws. Despite their benefit, there is still a gap between developing a Bayesian network that has a good predictive accuracy and having a model that makes a significant difference to clinical decision making. This thesis tries to bridge that gap and proposes three novel contributions. The first contribution is a modelling approach that captures the progress of an acute condition and the dynamic way that clinicians gather information and take decisions in irregular stages of care. The proposed method shows how to design a model to generate predictions with the potential to support decision making in successive stages of care. The second contribution is to show how counterfactual reasoning with a Bayesian network can be used as a healthcare governance tool to estimate the effect of treatment decisions other than those occurred. In addition, we extend counterfactual reasoning in situations where the targeted decision and its effect belong to different stages of the patient’s care. The third contribution is an explanation of the Bayesian network’s reasoning. No model is going to be used if it is unclear how it reasons. Presenting an explanation, alongside a prediction, has the potential to increase the acceptability of the network. The proposed technique indicates which important evidence supports or contradicts the prediction and through which intermediate variables the information flows. The above contributions are explored using two clinical case studies. A clinical case study on combat trauma care is used to investigate the first two contributions. The third contribution is explored using a Bayesian network developed by others to provide decision support in treating acute traumatic coagulopathy in the emergency department. Both case studies are done in collaboration with the Royal London Hospital and the Royal Centre for Defence Medicine

Computerized tongue diagnosis based on Bayesian networks

2004-2005 > Academic research: refereed > Publication in refereed journalVersion of RecordPublishe

Aircraft electrical power system diagnostics, prognostics and health management

In recent years, the loads needing electrical power in military aircraft and civil jet keep increasing, this put huge pressure on the electrical power system (EPS). As EPS becomes more powerful and complex, its reliability and maintenance becomes difficult problems to designers, manufacturers and customers. To improve the mission reliability and reduce life cycle cost, the EPS needs health management. This thesis developed a set of generic health management methods for the EPS, which can monitor system status; diagnose faults/failures in component level correctly and predict impending faults/failures exactly and predict remaining useful life of critical components precisely. The writer compared a few diagnostic and prognostic approaches in detail, and then found suitable ones for EPS. Then the major components and key parameters needed to be monitored are obtained, after function hazard analysis and failure modes effects analysis of EPS. A diagnostic process is applied to EPS using Dynamic Case-based Reasoning approach, whilst hybrid prognostic methods are suggested to the system. After that, Diagnostic, Prognostic and Health Management architecture of EPS is built up in system level based on diagnostic and prognostic process. Finally, qualitative evaluations of DPHM explain given. This research is an extension of group design project (GDP) work, the GDP report is arranged in the Appendix A

Integrated NDE Methods Using Data Fusion-For Bridge Condition Assessment

Bridge management system (BMS) is an effective mean for managing bridges throughout their design life. BMS requires accurate collection of data pertinent to bridge conditions. Non Destructive Evaluation methods (NDE) are automated accurate tools used in BMS to supplement visual inspection. This research provides overview of current practices in bridge inspection and in-depth study of thirteen NDE methods for condition assessment of concrete bridges and eleven for structural steel bridges. The unique characteristics, advantages and limitations of each method are identified along with feedback on their use in practice. Comparative study of current practices in bridge condition rating, with emphasis on the United States and Canada is also performed. The study includes 4 main criteria: inspection levels, inspection principles, inspection frequencies and numerical ratings for 4 provinces and states in North America and 5 countries outside North America. Considerable work has been carried out using a number of sensing technologies for condition assessment of civil infrastructure. Fewer efforts, however, have been directed for integrating the use of these technologies. This research presents a newly developed method for automated condition assessment and rating of concrete bridge decks. The method integrates the use of ground penetrating radar (GPR) and infrared thermography (IR) technologies. It utilizes data fusion at pixel and feature levels to improve the accuracy of detecting defects and, accordingly, that of condition assessment. Dynamic Bayesian Network (DBN) is utilized at the decision level of data fusion to overcome cited limitations of Markov chain type models in predicting bridge conditions based on prior inspection results. Pixel level image fusion is applied to assess the condition of a bridge deck in Montreal, Canada using GPR and IR inspection results. GPR data are displayed as 3D from 24 scans equally spaced by 0.33m to interpret a section of the bridge deck surface. The GPR data is fused with IR images using wavelet transform technique. Four scenarios based on image processing are studied and their application before and after data fusion is assessed in relation to accuracy of the employed fusion process. Analysis of the results showed that bridge condition assessment can be improved with image fusion and, accordingly, support inspectors in interpretation of the results obtained. The results also indicate that predicted bridge deck condition using the developed method is very close to the actual condition assessment and rating reported by independent inspection. The developed method was also applied and validated using three case studies of reinforced concrete bridge decks. Data and measurements of multiple NDE methods are extracted from Iowa, Highway research board project, 2011. The method utilizes data collected from ground penetrating radar (GPR), impact echo (IE), Half-cell potential (HCP) and electrical resistivity (ER). The analysis results of the three cases indicate that each level of data fusion has its unique advantage. The power of pixel level fusion lies in combining the location of bridge deck deterioration in one map as it appears in the fused image. While, feature fusion works in identification of specific types of defects, such as corrosion, delamination and deterioration. The main findings of this research recommend utilization of data fusion within two levels as a new method to facilitate and enhance the capabilities of inspectors in interpretation of the results obtained. To demonstrate the use of the developed method and its model at the decision level of data fusion an additional case study of a bridge deck in New Jersey, USA is selected. Measurements of NDE methods for years 2008 and 2013 for that bridge deck are used as input to the developed method. The developed method is expected to improve current practice in forecasting bridge deck deterioration and in estimating the frequency of inspection. The results generated from the developed method demonstrate its comprehensive and relatively more accurate diagnostics of defects

Investigating the neural basis of self-awareness deficits following traumatic brain injury

Self-awareness deficits are a common and disabling consequence of traumatic brain injury (TBI). ‘On-line’ awareness is one facet of self-awareness that can be studied by examining how people monitor their performance and respond to their errors. Performance monitoring, like many of the cognitive functions disrupted after TBI, is believed to depend on the coordinated activity of neural networks. The fronto-parietal control network (FPCN) is one such network that contains a sub-network called the salience network (SN). The SN consists of the dorsal anterior cingulate (dACC) and bilateral insulae cortex and is thought to monitor salient events (e.g. errors). I used advanced structure and function MRI techniques to investigate these networks and test two overarching hypotheses: first, performance monitoring is regulated by regions within the FPCN; and second, dysfunction of the FPCN leads to impaired self-awareness after TBI. My first study demonstrated two distinct frontal networks that respond to different error types. Predictable/internally signalled errors caused SN activation; whereas unpredictable/externally signalled errors caused activation of the ventral attentional network, a network thought to respond to unexpected events. This suggested the presence of parallel performance monitoring systems within the FPCN. My second study established that the ‘driving’ input into the SN originated in right anterior insula and subsequent behavioural adaptation was regulated by enhanced effective connectivity from the dACC to the left anterior insula. In my third study I identified a large group of TBI patients with impaired performance monitoring. These patients had additional metacognitive evidence of impaired self-awareness and demonstrated reduced functional connectivity between the dACC and the remainder of the FPCN at ‘rest’, and abnormally large insulae activation in response to errors. These studies clarified how the brain monitors and responds to salient events; and, provided evidence that self-awareness deficits after TBI are due to FPCN dysfunction, identifying this network as a potential target for future treatments.Open Acces