96 research outputs found
Addressing the challenge of integrated care through digital technology
There is a need to constantly tackle a range of diverse and, sometimes, contradictory requirements of people with multiple chronic conditions. Integrated Care provides a potential solution to this need and digital technology can be the proposition for addressing its implementation challenge. Digital technology can support clinical teams to achieve care across all levels and provide independence in patients’ lives, by supporting them in enhanced and integrated activity within our societal structures
Trust-based social mechanism to counter deceptive behaviour
The actions of an autonomous agent are driven by its individual goals and its knowledge and beliefs about its environment. As agents can be assumed to be selfinterested, they strive to achieve their own interests and therefore their behaviour can sometimes be difficult to predict. However, some behaviour trends can be observed and used to predict the future behaviour of agents, based on their past behaviour. This is useful for agents to minimise the uncertainty of interactions and ensure more successful transactions. Furthermore, uncertainty can originate from malicious behaviour, in the form of collusion, for example. Agents need to be able to cope with this to maximise their benefits and reduce poor interactions with collusive agents. This thesis provides a mechanism to support countering deceptive behaviour by enabling agents to model their agent environment, as well as their trust in the agents they interact with, while using the data they already gather during routine agent interactions. As agents interact with one another to achieve the goals they cannot achieve alone, they gather information for modelling the trust and reputation of interaction partners. The main aim of our trust and reputation model is to enable agents to select the most trustworthy partners to ensure successful transactions, while gathering a rich set of interaction and recommendation information. This rich set of information can be used for modelling the agents' social networks. Decentralised systems allow agents to control and manage their own actions, but this suffers from limiting the agents' view to only local interactions. However, the representation of the social networks helps extend an agent's view and thus extract valuable information from its environment. This thesis presents how agents can build such a model of their agent networks and use it to extract information for analysis on the issue of collusion detection.EThOS - Electronic Theses Online ServiceUniversity of Warwick. Dept. of Computer ScienceGBUnited Kingdo
A hybrid EAV-relational model for consistent and scalable capture of clinical research data
Many clinical research databases are built for specific purposes and their design is often guided by the requirements of their particular setting. Not only does this lead to issues of interoperability and reusability between research groups in the wider community but, within the project itself, changes and additions to the system could be implemented using an ad hoc approach, which may make the system difficult to maintain and even more difficult to share. In this paper, we outline a hybrid Entity-Attribute-Value and relational model approach for modelling data, in light of frequently changing requirements, which enables the back-end database schema to remain static, improving the extensibility and scalability of an application. The model also facilitates data reuse. The methods used build on the modular architecture previously introduced in the CURe project
E-health for active ageing : a systematic review
Enabling successful active ageing is an international priority to meet the challenges of increasing life expectancy. Digital strategies, such as telemedicine and e-health, offer the potential to deliver active ageing in a cost-effective manner at scale. This article aims to establish the extent to which the research literature considers e-health-based and telemedicine-based active ageing interventions. A systematic review was conducted according to PRISMA standards. Independently, two authors searched the Cochrane, EMBASE & CINAHL databases, with subsequent independent extraction and semi-quantitative analysis. We report a considerable breadth in digital active ageing research, which is truly international in its scope. There is a diverse range of both interventions and technologies, including a reassuring focus on community-based interventions. Whilst there are a number of quantitative studies, sample sizes are small, with a limited amount of statistical testing of the results. There is significant variation in the outcome measures reported and little consensus as to the most effective intervention strategies. Overall, whilst there is considerable breadth to the research published in the literature, there is a clear restriction in the depth of this research. There is little overall consensus. This lack of depth and consensus may be due to the need to recognize the important role of technical research elements alongside more traditional research methodologies, such as randomized controlled trials. Enabling both technical and clinical research methods to be recognized, in tandem, has enormous potential to support individuals, communities, clinicians and policy makers to make more informed decisions in relation to active ageing
A BioPortal-based terminology service for health data interoperability
A terminology service makes diverse terminologies/ontologies accessible under a uniform interface. The EU TRANSFoRm project built an online terminology service for European primary care research. The service experienced performance limitations during its operation. Based on community feedback, we evaluated alternative solutions and developed a new version of the service. Based on BioPortal’s scalable infrastructure, the new service delivers more features with improved performance and reduced maintenance cost. We plan to extend the service to meet Fast Healthcare Interoperability Resources specifications
Clinical Decision Support Systems for Brain Tumour Diagnosis and Prognosis:A Systematic Review
Computer-interpretable guidelines driven clinical decision support systems : an approach to the treatment personalisation routes of patients with multi-diseases
Clinical Decision Support Systems help the delivery of care by supplementing generic clinical guidelines with decision support. This is achieved by encompassing patient specific recommendations that support the implementation of the computer-interpretable guidelines (CIGs). CIG implementation involves understanding the risks and outcomes of a treatment, which may show diversifications between patients with multiple diseases and those without. The objective of this study is to present a state-of-the-art approach for CIG based treatment personalisation routes and stages for patients with multiple diseases
Diabetes and the direct secondary use of electronic health records : using routinely collected and stored data to drive research and understanding
Introduction
Electronic health records provide an unparalleled opportunity for the use of patient data that is routinely collected and stored, in order to drive research and develop an epidemiological understanding of disease. Diabetes, in particular, stands to benefit, being a data-rich, chronic-disease state. This article aims to provide an understanding of the extent to which the healthcare sector is using routinely collected and stored data to inform research and epidemiological understanding of diabetes mellitus.
Methods
Narrative literature review of articles, published in both the medical- and engineering-based informatics literature.
Results
There has been a significant increase in the number of papers published, which utilise electronic health records as a direct data source for diabetes research. These articles consider a diverse range of research questions. Internationally, the secondary use of electronic health records, as a research tool, is most prominent in the USA. The barriers most commonly described in research studies include missing values and misclassification, alongside challenges of establishing the generalisability of results.
Discussion
Electronic health record research is an important and expanding area of healthcare research. Much of the research output remains in the form of conference abstracts and proceedings, rather than journal articles. There is enormous opportunity within the United Kingdom to develop these research methodologies, due to national patient identifiers. Such a healthcare context may enable UK researchers to overcome many of the barriers encountered elsewhere and thus to truly unlock the potential of electronic health records
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