Evidence-based rules from family practice to inform family practice; The learning healthcare system case study on urinary tract infections

Background: Analysis of encounter data relevant to the diagnostic process sourced from routine electronic medical record (EMR) databases represents a classic example of the concept of a learning healthcare system (LHS). By collecting International Classification of Primary Care (ICPC) coded EMR data as part of the Transition Project from Dutch and Maltese databases (using the EMR TransHIS), data mining algorithms can empirically quantify the relationships of all presenting reasons for encounter (RfEs) and recorded diagnostic outcomes. We have specifically looked at new episodes of care (EoC) for two urinary system infections: simple urinary tract infection (UTI, ICPC code: U71) and pyelonephritis (ICPC code: U70). Methods: Participating family doctors (FDs) recorded details of all their patient contacts in an EoC structure using the ICPC, including RfEs presented by the patient, and the FDs' diagnostic labels. The relationships between RfEs and episode titles were studied using probabilistic and data mining methods as part of the TRANSFoRm project. Results: The Dutch data indicated that the presence of RfE's "Cystitis/Urinary Tract Infection", "Dysuria", "Fear of UTI", "Urinary frequency/urgency", "Haematuria", "Urine symptom/complaint, other" are all strong, reliable, predictors for the diagnosis "Cystitis/Urinary Tract Infection". The Maltese data indicated that the presence of RfE's "Dysuria", "Urinary frequency/urgency", "Haematuria" are all strong, reliable, predictors for the diagnosis "Cystitis/Urinary Tract Infection". The Dutch data indicated that the presence of RfE's "Flank/axilla symptom/complaint", "Dysuria", "Fever", "Cystitis/Urinary Tract Infection", "Abdominal pain/cramps general" are all strong, reliable, predictors for the diagnosis "Pyelonephritis". The Maltese data set did not present any clinically and statistically significant predictors for pyelonephritis. Conclusions: We describe clinically and statistically significant diagnostic associations observed between UTIs and pyelonephritis presenting as a new problem in family practice, and all associated RfEs, and demonstrate that the significant diagnostic cues obtained are consistent with the literature. We conclude that it is possible to generate clinically meaningful diagnostic evidence from electronic sources of patient data

An Introduction to Community Detection in Multi-layered Social Network

Social communities extraction and their dynamics are one of the most important problems in today's social network analysis. During last few years, many researchers have proposed their own methods for group discovery in social networks. However, almost none of them have noticed that modern social networks are much more complex than few years ago. Due to vast amount of different data about various user activities available in IT systems, it is possible to distinguish the new class of social networks called multi-layered social network. For that reason, the new approach to community detection in the multi-layered social network, which utilizes multi-layered edge clustering coefficient is proposed in the paper.Comment: M.D. Lytras et al. (Eds.): WSKS 2011, CCIS 278, pp. 185-190, 201

Analysis of group evolution prediction in complex networks.

In the world, in which acceptance and the identification with social communities are highly desired, the ability to predict the evolution of groups over time appears to be a vital but very complex research problem. Therefore, we propose a new, adaptable, generic, and multistage method for Group Evolution Prediction (GEP) in complex networks, that facilitates reasoning about the future states of the recently discovered groups. The precise GEP modularity enabled us to carry out extensive and versatile empirical studies on many real-world complex / social networks to analyze the impact of numerous setups and parameters like time window type and size, group detection method, evolution chain length, prediction models, etc. Additionally, many new predictive features reflecting the group state at a given time have been identified and tested. Some other research problems like enriching learning evolution chains with external data have been analyzed as well

A degree centrality in multi-layered social network

Multi-layered social networks reflect complex relationships existing in modern interconnected IT systems. In such a network each pair of nodes may be linked by many edges that correspond to different communication or collaboration user activities. Multi-layered degree centrality for multi-layered social networks is presented in the paper. Experimental studies were carried out on data collected from the real Web 2.0 site. The multi-layered social network extracted from this data consists of ten distinct layers and the network analysis was performed for different degree centralities measures

GED: the method for group evolution discovery in social networks

The continuous interest in the social network area contributes to the fast development of this field. The new possibilities of obtaining and storing data facilitate deeper analysis of the entire network, extracted social groups and single individuals as well. One of the most interesting research topic is the dynamics of social groups, it means analysis of group evolution over time. Having appropriate knowledge and methods for dynamic analysis, one may attempt to predict the future of the group, and then manage it properly in order to achieve or change this predicted future according to specific needs. Such ability would be a powerful tool in the hands of human resource managers, personnel recruitment, marketing, etc. The social group evolution consists of individual events and seven types of such changes have been identified in the paper: continuing, shrinking, growing, splitting, merging, dissolving and forming. To enable the analysis of group evolution a change indicator - inclusion measure was proposed. It has been used in a new method for exploring the evolution of social groups, called Group Evolution Discovery (GED). The experimental results of its use together with the comparison to two well-known algorithms in terms of accuracy, execution time, flexibility and ease of implementation are also described in the paper.Comment: 14 pages, Social Network Analysis and Minin

Molecular Model of Dynamic Social Network Based on E-mail communication

In this work we consider an application of physically inspired sociodynamical model to the modelling of the evolution of email-based social network. Contrary to the standard approach of sociodynamics, which assumes expressing of system dynamics with heuristically defined simple rules, we postulate the inference of these rules from the real data and their application within a dynamic molecular model. We present how to embed the n-dimensional social space in Euclidean one. Then, inspired by the Lennard-Jones potential, we define a data-driven social potential function and apply the resultant force to a real e-mail communication network in a course of a molecular simulation, with network nodes taking on the role of interacting particles. We discuss all steps of the modelling process, from data preparation, through embedding and the molecular simulation itself, to transformation from the embedding space back to a graph structure. The conclusions, drawn from examining the resultant networks in stable, minimum-energy states, emphasize the role of the embedding process projecting the non–metric social graph into the Euclidean space, the significance of the unavoidable loss of information connected with this procedure and the resultant preservation of global rather than local properties of the initial network. We also argue applicability of our method to some classes of problems, while also signalling the areas which require further research in order to expand this applicability domain

Analysis of Neighbourhoods in Multi-layered Dynamic Social Networks

Social networks existing among employees, customers or users of various IT systems have become one of the research areas of growing importance. A social network consists of nodes - social entities and edges linking pairs of nodes. In regular, one-layered social networks, two nodes - i.e. people are connected with a single edge whereas in the multi-layered social networks, there may be many links of different types for a pair of nodes. Nowadays data about people and their interactions, which exists in all social media, provides information about many different types of relationships within one network. Analysing this data one can obtain knowledge not only about the structure and characteristics of the network but also gain understanding about semantic of human relations. Are they direct or not? Do people tend to sustain single or multiple relations with a given person? What types of communication is the most important for them? Answers to these and more questions enable us to draw conclusions about semantic of human interactions. Unfortunately, most of the methods used for social network analysis (SNA) may be applied only to one-layered social networks. Thus, some new structural measures for multi-layered social networks are proposed in the paper, in particular: cross-layer clustering coefficient, cross-layer degree centrality and various versions of multi-layered degree centralities. Authors also investigated the dynamics of multi-layered neighbourhood for five different layers within the social network. The evaluation of the presented concepts on the real-world dataset is presented. The measures proposed in the paper may directly be used to various methods for collective classification, in which nodes are assigned to labels according to their structural input features.Comment: 16 pages, International Journal of Computational Intelligence System

Finding co-solvers on Twitter, with a little help from Linked Data

In this paper we propose a method for suggesting potential collaborators for solving innovation challenges online, based on their competence, similarity of interests and social proximity with the user. We rely on Linked Data to derive a measure of semantic relatedness that we use to enrich both user profiles and innovation problems with additional relevant topics, thereby improving the performance of co-solver recommendation. We evaluate this approach against state of the art methods for query enrichment based on the distribution of topics in user profiles, and demonstrate its usefulness in recommending collaborators that are both complementary in competence and compatible with the user. Our experiments are grounded using data from the social networking service Twitter.com

Requirements and validation of a prototype learning health system for clinical diagnosis

Introduction Diagnostic error is a major threat to patient safety in the context of family practice. The patient safety implications are severe for both patient and clinician. Traditional approaches to diagnostic decision support have lacked broad acceptance for a number of well-documented reasons: poor integration with electronic health records and clinician workflow, static evidence that lacks transparency and trust, and use of proprietary technical standards hindering wider interoperability. The learning health system (LHS) provides a suitable infrastructure for development of a new breed of learning decision support tools. These tools exploit the potential for appropriate use of the growing volumes of aggregated sources of electronic health records. Methods We describe the experiences of the TRANSFoRm project developing a diagnostic decision support infrastructure consistent with the wider goals of the LHS. We describe an architecture that is model driven, service oriented, constructed using open standards, and supports evidence derived from electronic sources of patient data. We describe the architecture and implementation of 2 critical aspects for a successful LHS: the model representation and translation of clinical evidence into effective practice and the generation of curated clinical evidence that can be used to populate those models, thus closing the LHS loop. Results/Conclusions Six core design requirements for implementing a diagnostic LHS are identified and successfully implemented as part of this research work. A number of significant technical and policy challenges are identified for the LHS community to consider, and these are discussed in the context of evaluating this work: medico-legal responsibility for generated diagnostic evidence, developing trust in the LHS (particularly important from the perspective of decision support), and constraints imposed by clinical terminologies on evidence generation