Temporal detection and analysis of guideline interactions

Background Clinical practice guidelines (CPGs) are assuming a major role in the medical area, to grant the quality of medical assistance, supporting physicians with evidence-based information of interventions in the treatment of single pathologies. The treatment of patients affected by multiple diseases (comorbid patients) is one of the main challenges for the modern healthcare. It requires the development of new methodologies, supporting physicians in the treatment of interactions between CPGs. Several approaches have started to face such a challenging problem. However, they suffer from a substantial limitation: they do not take into account the temporal dimension. Indeed, practically speaking, interactions occur in time. For instance, the effects of two actions taken from different guidelines may potentially conflict, but practical conflicts happen only if the times of execution of such actions are such that their effects overlap in time. Objectives We aim at devising a methodology to detect and analyse interactions between CPGs that considers the temporal dimension. Methods In this paper, we first extend our previous ontological model to deal with the fact that actions, goals, effects and interactions occur in time, and to model both qualitative and quantitative temporal constraints between them. Then, we identify different application scenarios, and, for each of them, we propose different types of facilities for user physicians, useful to support the temporal detection of interactions. Results We provide a modular approach in which different Artificial Intelligence temporal reasoning techniques, based on temporal constraint propagation, are widely exploited to provide users with such facilities. We applied our methodology to two cases of comorbidities, using simplified versions of CPGs. Conclusion We propose an innovative approach to the detection and analysis of interactions between CPGs considering different sources of temporal information (CPGs, ontological knowledge and execution logs), which is the first one in the literature that takes into account the temporal issues, and accounts for different application scenarios

Building a Persuasive Virtual Dietitian

This paper describes the Multimedia Application for Diet Management (MADiMan), a system that supports users in managing their diets while admitting diet transgressions. MADiMan consists of a numerical reasoner that takes into account users’ dietary constraints and automatically adapts the users’ diet, and of a natural language generation (NLG) system that automatically creates textual messages for explaining the results provided by the reasoner with the aim of persuading users to stick to a healthy diet. In the first part of the paper, we introduce the MADiMan system and, in particular, the basic mechanisms related to reasoning, data interpretation and content selection for a numeric data-to-text NLG system. We also discuss a number of factors influencing the design of the textual messages produced. In particular, we describe in detail the design of the sentence-aggregation procedure, which determines the compactness of the final message by applying two aggregation strategies. In the second part of the paper, we present the app that we developed, CheckYourMeal!, and the results of two human-based quantitative evaluations of the NLG module conducted using CheckYourMeal! in a simulation. The first evaluation, conducted with twenty users, ascertained both the perceived usefulness of graphics/text and the appeal, easiness and persuasiveness of the textual messages. The second evaluation, conducted with thirty-nine users, ascertained their persuasive power. The evaluations were based on the analysis of questionnaires and of logged data of users’ behaviour. Both evaluations showed significant results

Reasoning and querying bounds on differences with layered preferences

Artificial intelligence largely relies on bounds on differences (BoDs) to model binary constraints regarding different dimensions, such as time, space, costs, and calories. Recently, some approaches have extended the BoDs framework in a fuzzy, \u201cnoncrisp\u201d direction, considering probabilities or preferences. While previous approaches have mainly aimed at providing an optimal solution to the set of constraints, we propose an innovative class of approaches in which constraint propagation algorithms aim at identifying the \u201cspace of solutions\u201d (i.e., the minimal network) with their preferences, and query answering mechanisms are provided to explore the space of solutions as required, for example, in decision support tasks. Aiming at generality, we propose a class of approaches parametrized over user\u2010defined scales of qualitative preferences (e.g., Low, Medium, High, and Very High), utilizing the resume and extension operations to combine preferences, and considering different formalisms to associate preferences with BoDs. We consider both \u201cgeneral\u201d preferences and a form of layered preferences that we call \u201cpyramid\u201d preferences. The properties of the class of approaches are also analyzed. In particular, we show that, when the resume and extension operations are defined such that they constitute a closed semiring, a more efficient constraint propagation algorithm can be used. Finally, we provide a preliminary implementation of the constraint propagation algorithms