D-WISE: Diabetes Web-Centric Information and Support Environment: Conceptual Specification and Proposed Evaluation

AbstractObjectiveTo develop and evaluate Diabetes Web-Centric Information and Support Environment (D-WISE) that offers 1) a computerized decision-support system to assist physicians to A) use the Canadian Diabetes Association clinical practice guidelines (CDA CPGs) to recommend evidence-informed interventions; B) offer a computerized readiness assessment strategy to help physicians administer behaviour-change strategies to help patients adhere to disease self-management programs; and 2) a patient-specific diabetes self-management application, accessible through smart mobile devices, that offers behaviour-change interventions to engage patients in self-management.MethodsThe above-mentioned objectives were pursued through a knowledge management approach that involved 1) Translation of paper-based CDA CPGs and behaviour-change models as computerized decision-support tools that will assist physicians to offer evidence-informed and personalized diabetes management and behaviour-change strategies; 2) Engagement of patients in their diabetes care by generating a diabetes self-management program that takes into account their preferences, challenges and needs; 3) Empowering patients to self-manage their condition by providing them with personalized educational and motivational messages through a mobile self-management application. The theoretical foundation of our research is grounded in behaviour-change models and healthcare knowledge management.We used 1) knowledge modelling to computerize the paper-based CDA CPGs and behaviour-change models, in particular, the behaviour-change strategy elements of A) readiness-to-change assessments; B) motivation-enhancement interventions categorized along the lines of patients' being ready, ambivalent or not ready; and C) self-efficacy enhancement. The CDA CPGs and the behaviour-change models are modelled and computerized in terms of A) a diabetes management ontology that serves as the knowledge resource for all the services offered by D-WISE; B) decision support services that use logic-based reasoning algorithms to utilize the knowledge encoded within the diabetes management ontology to assist physicians by recommending patient-specific diabetes-management interventions and behaviour-change strategies; C) a mobile diabetes self-management application to engage and educate diabetes patients to self-manage their condition in a home-based setting while working in concert with their family physicians.ResultsWe have been successful in creating and conducting a usability assessment of the physician decision support tool. These results will be published once the patient self- management application has been evaluated.ConclusionsD-WISE will be evaluated through pilot studies measuring 1) the usability of the e-Health interventions; and 2) the impact of the interventions on patients' behaviour changes and diabetes control

Towards a framework for comparing functionalities of multimorbidity clinical decision support: A literature-based feature set and benchmark cases.

Multimorbidity, the coexistence of two or more health conditions, has become more prevalent as mortality rates in many countries have declined and their populations have aged. Multimorbidity presents significant difficulties for Clinical Decision Support Systems (CDSS), particularly in cases where recommendations from relevant clinical guidelines offer conflicting advice. A number of research groups are developing computer-interpretable guideline (CIG) modeling formalisms that integrate recommendations from multiple Clinical Practice Guidelines (CPGs) for knowledge-based multimorbidity decision support. In this paper we describe work towards the development of a framework for comparing the different approaches to multimorbidity CIG-based clinical decision support (MGCDS). We present (1) a set of features for MGCDS, which were derived using a literature review and evaluated by physicians using a survey, and (2) a set of benchmarking case studies, which illustrate the clinical application of these features. This work represents the first necessary step in a broader research program aimed at the development of a benchmark framework that allows for standardized and comparable MGCDS evaluations, which will facilitate the assessment of functionalities of MGCDS, as well as highlight important gaps in the state-of-the-art. We also outline our future work on developing the framework, specifically, (3) a standard for reporting MGCDS solutions for the benchmark case studies, and (4) criteria for evaluating these MGCDS solutions. We plan to conduct a large-scale comparison study of existing MGCDS based on the comparative framework

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Sentiment Analysis on COVID-19-Related Social Distancing in Canada Using Twitter Data

Background: COVID-19 preventive measures have been an obstacle to millions of people around the world, influencing not only their normal day-to-day activities but also affecting their mental health. Social distancing is one such preventive measure. People express their opinions freely through social media platforms like Twitter, which can be shared among other users. The articulated texts from Twitter can be analyzed to find the sentiments of the public concerning social distancing. Objective: To understand and analyze public sentiments towards social distancing as articulated in Twitter textual data. Methods: Twitter data specific to Canada and texts comprising social distancing keywords were extrapolated, followed by utilizing the SentiStrength tool to extricate sentiment polarity of tweet texts. Thereafter, the support vector machine (SVM) algorithm was employed for sentiment classification. Evaluation of performance was measured with a confusion matrix, precision, recall, and F1 measure. Results: This study resulted in the extraction of a total of 629 tweet texts, of which, 40% of tweets exhibited neutral sentiments, followed by 35% of tweets showed negative sentiments and only 25% of tweets expressed positive sentiments towards social distancing. The SVM algorithm was applied by dissecting the dataset into 80% training and 20% testing data. Performance evaluation resulted in an accuracy of 71%. Upon using tweet texts with only positive and negative sentiment polarity, the accuracy increased to 81%. It was observed that reducing test data by 10% increased the accuracy to 87%. Conclusion: Results showed that an increase in training data increased the performance of the algorithm

A Case for Supplementing Evidence Base Medicine with Inductive Clinical Knowledge: Towards a Technology-Enriched Integrated Clinical Evidence System

Clinical evidence exist in modalities other than published clinical literature, such as clinical data ranging from patient clinical profiles to clinical trials; clinical experiences of eminent medical practitioners; and medical knowledge bases encapsulating knowledge about patient care, healthcare guidelines and protocols, clinical workflow and so on. We propose a technology-enriched strategy to exploit advance computer technologies—Knowledge Management, Data Mining, Case Based Reasoning Strategies and Internet Technology— within traditional Evidence Based Medicine systems to derive all-encompassing clinical evidence derived from heterogeneous clinical evidence modalities. The paper features a conceptual overview of an Integrated Clinical Evidence System designed to augment the typical literature-based clinical evidence with additional technology-mediated clinical evidence. 1

Semantic Web Framework for Knowledge-Centric Clinical Decision Support Systems

Abstract. Lately, there have been considerable efforts to computerize Clinical Practice Guidelines (CPG) so that they can be executed via Clinical Decision Support Systems (CDSS) at the point of care. We present a Semantic Web framework to both model and execute the knowledge within a CPG to develop knowledge-centric CDSS. Our approach entails knowledge modeling through a synergy between multiple ontologies–i.e. a domain ontology, CPG ontology and patient ontology. We develop decision-rules based on the ontologies, and execute them with a proof engine to derive CPG-based patient specific recommendations. We present a prototype of our CPG-based CDSS to execute the CPG for Follow-up after Treatment for Breast Cancer