Argumentation Theory in Health Care

Argumentation theory (AT) has been gaining momentum in the health care arena thanks to its intuitive and modular way of aggregating clinical evidence and taking rational decisions. The basic principles of argumentation theory are described and demonstrated in the breast cancer recurrence problem. It is shown how to represent available clinical evidence in arguments, how to define defeat relations among them and how to create a formal argumentation framework. Argumentation semantics are then applied over the built framework to compute arguments justification status. It is demonstrated how this process can enhance the clinician decision-making process. A encouraging predictive capacity is compared against the accuracy rate of well established machine learning techniques confirming the potential of argumentation theory in health care

Towards Exchanging Wearable-PGHD with EHRs: Developing a Standardized Information Model for Wearable-Based Patient Generated Health Data

Wearables have become commonplace for tracking and making sense of patient lifestyle, wellbeing and health data. Most of this tracking is done by individuals outside of clinical settings, however some data from wearables may be useful in a clinical context. As such, wearables may be considered a prominent source of Patient Generated Health Data (PGHD). Studies have attempted to maximize the use of the data from wearables including integrating with Electronic Health Records (EHRs). However, usually a limited number of wearables are considered for integration and, in many cases, only one brand is investigated. In addition, we find limited studies on integration of metadata including data quality and provenance, despite such data being very relevant for clinical decision making. This paper describes a proposed design and development of a generic information model for wearable based PGHD integration with EHRs. We propose a vendor-neutral model that can work with a wider range of wearables and discuss our proposed method to employ an ontology-based approach and provide insights to future work

Patient generated health data and electronic health record integration, governance and socio-technical issues: A narrative review

Patients’ health records have the potential to include patient generated health data (PGHD), which can aid in the provision of personalized care. Access to these data can allow healthcare professionals to receive additional information that will assist in decision-making and the provision of additional support. Given the diverse sources of PGHD, this review aims to provide evidence on PGHD integration with electronic health records (EHR), models and standards for PGHD exchange with EHR, and PGHD-EHR policy design and development. The review also addresses governance and socio-technical considerations in PGHD management. Databases used for the review include PubMed, Scopus, ScienceDirect, IEEE Xplore, SpringerLink and ACM Digital Library. The review reveals the significance, but current deficiency, of provenance, trust and contextual information as part of PGHD integration with EHR. Also, we find that there is limited work on data quality, and on new data sources and associated data elements, within the design of existing standards developed for PGHD integration. New data sources from emerging technologies like mixed reality, virtual reality, interactive voice response system, and social media are rarely considered. The review recommends the need for well-developed designs and policies for PGHD-EHR integration that promote data quality, patient autonomy, privacy, and enhanced trust

Investigating the Use of Conversational Agents as Accountable Buddies to Support Health and Lifestyle Change

The poster focuses on the role of conversational agents in promoting health and well-being. Results of the literature review indicate that negative emotions can hinder individuals from taking necessary actions related to their health. The study concludes that understanding and addressing emotional barriers is essential to facilitating early access to health services and improving well-being. The poster outlines plans to investigate motivation strategies, develop a prototype conversational agent based on user study insights and chat log data, and incorporate emotion regulation to effectively manage users\u27 emotional experiences.https://arrow.tudublin.ie/cddpos/1013/thumbnail.jp

FAIR4PGHD: A framework for FAIR implementation over PGHD

Patient Generated Health Data (PGHD) are being considered for integration with health facilities, however little is known about how such data can be made machine-actionable in a way that meets FAIR guidelines. This article proposes a 5-stage framework that can be used to achieve this

Developing an electronic health record (EHR) for methadone treatment recording and decision support

Background: in this paper, we give an overview of methadone treatment in Ireland and outline the rationale for designing an electronic health record (EHR) with extensibility, interoperability and decision support functionality. Incorporating several international standards, a conceptual model applying a problem orientated approach in a hierarchical structure has been proposed for building the EHR.Methods: a set of archetypes has been designed in line with the current best practice and clinical guidelines which guide the information-gathering process. A web-based data entry system has been implemented, incorporating elements of the paper-based prescription form, while at the same time facilitating the decision support function.Results: the use of archetypes was found to capture the ever changing requirements in the healthcare domain and externalises them in constrained data structures. The solution is extensible enabling the EHR to cover medicine management in general as per the programme of the HRB Centre for Primary Care Research.Conclusions: the data collected via this Irish system can be aggregated into a larger dataset, if necessary, for analysis and evidence-gathering, since we adopted the openEHR standard. It will be later extended to include the functionalities of prescribing drugs other than methadone along with the research agenda at the HRB Centre for Primary Care Research in Irelan

Data quality and patient characteristics in European ANCA-associated vasculitis registries: data retrieval by federated querying

Objectives This study aims to describe the data structure and harmonisation process, explore data quality and define characteristics, treatment, and outcomes of patients across six federated antineutrophil cytoplasmic antibody-associated vasculitis (AAV) registries.Methods Through creation of the vasculitis-specific Findable, Accessible, Interoperable, Reusable, VASCulitis ontology, we harmonised the registries and enabled semantic interoperability. We assessed data quality across the domains of uniqueness, consistency, completeness and correctness. Aggregated data were retrieved using the semantic query language SPARQL Protocol and Resource Description Framework Query Language (SPARQL) and outcome rates were assessed through random effects meta-analysis.Results A total of 5282 cases of AAV were identified. Uniqueness and data-type consistency were 100% across all assessed variables. Completeness and correctness varied from 49%–100% to 60%–100%, respectively. There were 2754 (52.1%) cases classified as granulomatosis with polyangiitis (GPA), 1580 (29.9%) as microscopic polyangiitis and 937 (17.7%) as eosinophilic GPA. The pattern of organ involvement included: lung in 3281 (65.1%), ear-nose-throat in 2860 (56.7%) and kidney in 2534 (50.2%). Intravenous cyclophosphamide was used as remission induction therapy in 982 (50.7%), rituximab in 505 (17.7%) and pulsed intravenous glucocorticoid use was highly variable (11%–91%). Overall mortality and incidence rates of end-stage kidney disease were 28.8 (95% CI 19.7 to 42.2) and 24.8 (95% CI 19.7 to 31.1) per 1000 patient-years, respectively.Conclusions In the largest reported AAV cohort-study, we federated patient registries using semantic web technologies and highlighted concerns about data quality. The comparison of patient characteristics, treatment and outcomes was hampered by heterogeneous recruitment settings