Medical Knowledge Discovery Systems: Data Abstraction And Performance Measurement

Knowledge discovery systems can be traced back to their origin, artificial intelligence and expert systems, but use the modern technique of data mining for the knowledge discovery process. To that end, the technical community views data mining as one step in the knowledge discovery process, while the non-technical community seems to view it as encompassing all of the steps to knowledge discovery. In this exploratory study, we look at medical knowledge discovery systems (MKDSs) by first looking at three examples of expert systems to generate medical knowledge. We then expand on the use of data abstraction as a pre-processing step in the comprehensive task of medical knowledge discovery. Next, we look at how performance of a medical knowledge discovery system is measured. Finally, the conclusions point to a bright future for MKDSs, but an area that needs extensive development to reach its full potential

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

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

Exploratory Visualization of Data Pattern Changes in Multivariate Data Streams

More and more researchers are focusing on the management, querying and pattern mining of streaming data. The visualization of streaming data, however, is still a very new topic. Streaming data is very similar to time-series data since each datapoint has a time dimension. Although the latter has been well studied in the area of information visualization, a key characteristic of streaming data, unbounded and large-scale input, is rarely investigated. Moreover, most techniques for visualizing time-series data focus on univariate data and seldom convey multidimensional relationships, which is an important requirement in many application areas. Therefore, it is necessary to develop appropriate techniques for streaming data instead of directly applying time-series visualization techniques to it. As one of the main contributions of this dissertation, I introduce a user-driven approach for the visual analytics of multivariate data streams based on effective visualizations via a combination of windowing and sampling strategies. To help users identify and track how data patterns change over time, not only the current sliding window content but also abstractions of past data in which users are interested are displayed. Sampling is applied within each single time window to help reduce visual clutter as well as preserve data patterns. Sampling ratios scheduled for different windows reflect the degree of user interest in the content. A degree of interest (DOI) function is used to represent a user\u27s interest in different windows of the data. Users can apply two types of pre-defined DOI functions, namely RC (recent change) and PP (periodic phenomena) functions. The developed tool also allows users to interactively adjust DOI functions, in a manner similar to transfer functions in volume visualization, to enable a trial-and-error exploration process. In order to visually convey the change of multidimensional correlations, four layout strategies were designed. User studies showed that three of these are effective techniques for conveying data pattern changes compared to traditional time-series data visualization techniques. Based on this evaluation, a guide for the selection of appropriate layout strategies was derived, considering the characteristics of the targeted datasets and data analysis tasks. Case studies were used to show the effectiveness of DOI functions and the various visualization techniques. A second contribution of this dissertation is a data-driven framework to merge and thus condense time windows having small or no changes and distort the time axis. Only significant changes are shown to users. Pattern vectors are introduced as a compact format for representing the discovered data model. Three views, juxtaposed views, pattern vector views, and pattern change views, were developed for conveying data pattern changes. The first shows more details of the data but needs more canvas space; the last two need much less canvas space via conveying only the pattern parameters, but lose many data details. The experiments showed that the proposed merge algorithms preserves more change information than an intuitive pattern-blind averaging. A user study was also conducted to confirm that the proposed techniques can help users find pattern changes more quickly than via a non-distorted time axis. A third contribution of this dissertation is the history views with related interaction techniques were developed to work under two modes: non-merge and merge. In the former mode, the framework can use natural hierarchical time units or one defined by domain experts to represent timelines. This can help users navigate across long time periods. Grid or virtual calendar views were designed to provide a compact overview for the history data. In addition, MDS pattern starfields, distance maps, and pattern brushes were developed to enable users to quickly investigate the degree of pattern similarity among different time periods. For the merge mode, merge algorithms were applied to selected time windows to generate a merge-based hierarchy. The contiguous time windows having similar patterns are merged first. Users can choose different levels of merging with the tradeoff between more details in the data and less visual clutter in the visualizations. The usability evaluation demonstrated that most participants could understand the concepts of the history views correctly and finished assigned tasks with a high accuracy and relatively fast response time

Intelligent Decision Support Systems in Ventilation Management

Introduction: Intensive Care Unit (ICU) medical personnel, in an ongoing process termed ventilation management, utilize patient physiology and pathology data to define ventilator apparatus settings. Aims: The aim of the research is to develop and evaluate in comparison hybrid ventilation advisor systems, that could support ventilation management process, specific to lung pathology for patients ventilated in control mode. Methodology: A questionnaire was designed and circulated to Intensivists. Patient data, as defined by the questionnaire analysis, were collected and categorized into three lung pathologies. Three ICU doctors evaluated correlation analysis of the recorded data. Evaluation results were used for identifying models basic architecture. Two custom software toolboxes were developed for developing hybrid systems; namely the EVolution Of Fuzzy INference Engines (EVOFINE) and the FUzzy Neural (FUN) toolbox. Eight hybrid systems developed with EVOFINE, FUN, ANFIS and ANN techniques were evaluated against applied clinical decisions and patient scenarios. Results: Seventeen (17) models were designed for each of the eight (8) modeling techniques. The modelled process consisted of twelve physiology variables and six ventilator settings. The number of models’ inputs ranged from single to six based on correlation and evaluation findings. Evaluation against clinical recommendations has shown that ANNs performed better; mean average error as percentage for four of the applied techniques was 0.16%, 1.29% & 0.62 for ANN empirical, 0.05%, 2.23% & 2.30% for ANFIS, 0.93%, 2.33% & 1.89% for EVOFINE and 0.73%, 2.63% & 6.56 for FUN NM, in Normal, COPD and ALI-ARDS categories respectively. Additionally evaluation against clinical disagreement SD has shown that 70.6% of the NN empirical models were performing in 90% of their suggestions within clinical SD, while the percentages were 53%, 53% and 59% for the EVOFINE, ANFIS and NN Normalized models respectively. The EVOFINE and ANFIS produced Fuzzy Systems whose architecture is transparent for the user. Visual observation of ANFIS architectures revealed possibly hazardous advices. Evaluation against clinical disagreement has shown that the NN empirical was not producing hazardous advices, while EVOFINE, ANFIS and NN Normalized were shown to produce potentially hazardous advice in 17.6%, 23% and 5.8% of the developed models

Utilizing temporal data abstraction for data validation and therapy planning for artificially ventilated newborn infants

Abstract: Medical diagnosis and therapy planning at modern intensive care units (ICUs) have been refined by the technical improvement of their equipment. However, the bulk of continuous data arising from complex monitoring systems in combination with discontinuously assessed numerical and qualitative data creates a rising information management problem at neonatal ICUs (NICUs). We developed methods for data validation and therapy planning which incorporate knowledge about point and interval data, as well as expected qualitative trend descriptions to arrive at unified qualitative descriptions of parameters (temporal data abstraction). Our methods are based on schemata for data-point transformation and curve fitting which express the dynamics of and the reactions to different degrees of parameters ' abnormalities as well as on smoothing and adjustment mechanisms to keep the qualitative descriptions stable. We show their applicability in detecting anomalous system behavior early, in recommending therapeutic actions, and in assessing the effectiveness of these actions within a certain period. We implemented our methods in VIE-VENT, an open-loop knowledge-based monitoring and therapy planning system for artificially ventilated newborn infants. The applicability and usefulness of our approach are illustrated by examples of VIE-VENT. Finally, we present our first experiences with using VIE-VENT i

Efficient Decision Support Systems

This series is directed to diverse managerial professionals who are leading the transformation of individual domains by using expert information and domain knowledge to drive decision support systems (DSSs). The series offers a broad range of subjects addressed in specific areas such as health care, business management, banking, agriculture, environmental improvement, natural resource and spatial management, aviation administration, and hybrid applications of information technology aimed to interdisciplinary issues. This book series is composed of three volumes: Volume 1 consists of general concepts and methodology of DSSs; Volume 2 consists of applications of DSSs in the biomedical domain; Volume 3 consists of hybrid applications of DSSs in multidisciplinary domains. The book is shaped decision support strategies in the new infrastructure that assists the readers in full use of the creative technology to manipulate input data and to transform information into useful decisions for decision makers