Modeling and querying spatio-temporal clinical databases with multiple granularities

In molti campi di ricerca, i ricercatori hanno la necessit\ue0 di memorizzare, gestire e interrogare dati spazio-temporali. Tali dati sono classici dati alfanumerici arricchiti per\uf2 con una o pi\uf9 componenti temporali, spaziali e spazio-temporali che, con diversi possibili significati, li localizzano nel tempo e/o nello spazio. Ambiti in cui tali dati spazio-temporali devono essere raccolti e gestiti sono, per esempio, la gestione del territorio o delle risorse naturali, l'epidemiologia, l'archeologia e la geografia. Pi\uf9 in dettaglio, per esempio nelle ricerche epidemiologiche, i dati spazio-temporali possono servire a rappresentare diversi aspetti delle malattie e delle loro caratteristiche, quali per esempio la loro origine, espansione ed evoluzione e i fattori di rischio potenzialmente connessi alle malattie e al loro sviluppo. Le componenti spazio-temporali dei dati possono essere considerate come dei "meta-dati" che possono essere sfruttati per introdurre nuovi tipi di analisi sui dati stessi. La gestione di questi "meta-dati" pu\uf2 avvenire all'interno di diversi framework proposti in letteratura. Uno dei concetti proposti a tal fine \ue8 quello delle granularit\ue0. In letteratura c'\ue8 ampio consenso sul concetto di granularit\ue0 temporale, di cui esistono framework basati su diversi approcci. D'altro canto, non esiste invece un consenso generale sulla definizione di un framework completo, come quello delle granularit\ue0 temporali, per le granularit\ue0 spaziali e spazio-temporali. Questa tesi ha lo scopo di riempire questo vuoto proponendo un framework per le granularit\ue0 spaziali e, basandosi su questo e su quello gi\ue0 presente in letteratura per le granularit\ue0 temporali, un framework per le granularit\ue0 spazio-temporali. I framework proposti vogliono essere completi, per questo, oltre alle definizioni dei concetti di granularit\ue0 spaziale e spazio-temporale, includono anche la definizione di diversi concetti legati alle granularit\ue0, quali per esempio le relazioni e le operazioni tra granularit\ue0. Le relazioni permettono di conoscere come granularit\ue0 diverse sono legate tra loro, costruendone anche una gerarchia. Tali informazioni sono poi utili al fine di conoscere se e come \ue8 possibile confrontare dati associati e rappresentati con granularit\ue0 diverse. Le operazioni permettono invece di creare nuove granularit\ue0 a partire da altre granularit\ue0 gi\ue0 definite nel sistema, manipolando o selezionando alcune loro componenti. Basandosi su questi framework, l'obiettivo della tesi si sposta poi sul mostrare come le granularit\ue0 possano essere utilizzate per arricchire basi di dati spazio-temporali gi\ue0 esistenti al fine di una loro migliore e pi\uf9 ricca gestione e interrogazione. A tal fine, proponiamo qui una base di dati per la gestione dei dati riguardanti le granularit\ue0 temporali, spaziali e spazio-temporali. Nella base di dati proposta possono essere rappresentate tutte le componenti di una granularit\ue0 come definito nei framework proposti. La base di dati pu\uf2 poi essere utilizzata per estendere una base di dati spazio-temporale esistente aggiungendo alle tuple di quest'ultima delle referenze alle granularit\ue0 dove quei dati possono essere localizzati nel tempo e/o nel spazio. Per dimostrare come ci\uf2 possa essere fatto, nella tesi introduciamo la base di dati sviluppata ed utilizzata dal Servizio Psichiatrico Territoriale (SPT) di Verona. Tale base di dati memorizza le informazioni su tutti i pazienti venuti in contatto con l'SPT negli ultimi 30 anni e tutte le informazioni sui loro contatti con il servizio stesso (per esempio: chiamate telefoniche, visite a domicilio, ricoveri). Parte di tali informazioni hanno una componente spazio-temporale e possono essere quindi analizzate studiandone trend e pattern nel tempo e nello spazio. Nella tesi quindi estendiamo questa base di dati psichiatrica collegandola a quella proposta per la gestione delle granularit\ue0. A questo punto i dati psichiatrici possono essere interrogati anche sulla base di vincoli spazio-temporali basati su granularit\ue0. L'interrogazione di dati spazio-temporali associati a granularit\ue0 richiede l'utilizzo di un linguaggio d'interrogazione che includa, oltre a strutture, operatori e funzioni spazio-temporali per la gestione delle componenti spazio-temporali dei dati, anche costrutti per l'utilizzo delle granularit\ue0 nelle interrogazioni. Quindi, partendo da un linguaggio d'interrogazione spazio-temporale gi\ue0 presente in letteratura, in questa tesi proponiamo anche un linguaggio d'interrogazione che permetta ad un utente di recuperare dati da una base di dati spazio-temporale anche sulla base di vincoli basati su granularit\ue0. Il linguaggio viene introdotto fornendone la sintassi e la semantica. Inoltre per mostrare l'effettivo ruolo delle granularit\ue0 nell'interrogazione di una base di dati clinica, mostreremo diversi esempi di interrogazioni, scritte con il linguaggio d'interrogazione proposto, sulla base di dati psichiatrica dell'SPT di Verona. Tali interrogazioni spazio-temporali basate su granularit\ue0 possono essere utili ai ricercatori ai fini di analisi epidemiologiche dei dati psichiatrici.In several research fields, temporal, spatial, and spatio-temporal data have to be managed and queried with several purposes. These data are usually composed by classical data enriched with a temporal and/or a spatial qualification. For instance, in epidemiology spatio-temporal data may represent surveillance data, origins of disease and outbreaks, and risk factors. In order to better exploit the time and spatial dimensions, spatio-temporal data could be managed considering their spatio-temporal dimensions as meta-data useful to retrieve information. One way to manage spatio-temporal dimensions is by using spatio-temporal granularities. This dissertation aims to show how this is possible, in particular for epidemiological spatio-temporal data. For this purpose, in this thesis we propose a framework for the definition of spatio-temporal granularities (i.e., partitions of a spatio-temporal dimension) with the aim to improve the management and querying of spatio-temporal data. The framework includes the theoretical definitions of spatial and spatio-temporal granularities (while for temporal granularities we refer to the framework proposed by Bettini et al.) and all related notions useful for their management, e.g., relationships and operations over granularities. Relationships are useful for relating granularities and then knowing how data associated with different granularities can be compared. Operations allow one to create new granularities from already defined ones, manipulating or selecting their components. We show how granularities can be represented in a database and can be used to enrich an existing spatio-temporal database. For this purpose, we conceptually and logically design a relational database for temporal, spatial, and spatio-temporal granularities. The database stores all data about granularities and their related information we defined in the theoretical framework. This database can be used for enriching other spatio-temporal databases with spatio-temporal granularities. We introduce the spatio-temporal psychiatric case register, developed by the Verona Community-based Psychiatric Service (CPS), for storing and managing information about psychiatric patient, their personal information, and their contacts with the CPS occurred in last 30 years. The case register includes both clinical and statistical information about contacts, that are also temporally and spatially qualified. We show how the case register database can be enriched with spatio-temporal granularities both extending its structure and introducing a spatio-temporal query language dealing with spatio-temporal data and spatio-temporal granularities. Thus, we propose a new spatio-temporal query language, by defining its syntax and semantics, that includes ad-hoc features and constructs for dealing with spatio-temporal granularities. Finally, using the proposed query language, we report several examples of spatio-temporal queries on the psychiatric case register showing the ``usage'' of granularities and their role in spatio-temporal queries useful for epidemiological studies

Normalizing Spontaneous Reports into MedDRA: some Experiments with MagiCoder

Text normalization into medical dictionaries is useful to support clinical task. A typical setting is Pharmacovigilance (PV). The manual detection of suspected adverse drug reactions (ADRs) in narrative reports is time consuming and Natural Language Processing (NLP) provides a concrete help to PV experts. In this paper we carry on experiments for testing performances of MagiCoder, an NLP application designed to extract MedDRA terms from narrative clinical text. Given a narrative description, MagiCoder proposes an automatic encoding. The pharmacologist reviews, (possibly) corrects, and then validates the solution. This drastically reduces the time needed for the validation of reports with respect to a completely manual encoding. In previous work we mainly tested MagiCoder performances on Italian written spontaneous reports. In this paper, we include some new features, change the experiment design, and carry on more tests about MagiCoder. Moreover, we do a change of language, moving to English documents. In particular, we tested MagiCoder on the CADEC dataset, a corpus of manually annotated posts about ADRs collected from social media

From narrative descriptions to MedDRA: automagically encoding adverse drug reactions

The collection of narrative spontaneous reports is an irreplaceable source for the prompt detection of suspected adverse drug reactions (ADRs). In such task qualified domain experts manually revise a huge amount of narrative descriptions and then encode texts according to MedDRA standard terminology. The manual annotation of narrative documents with medical terminology is a subtle and expensive task, since the number of reports is growing up day-by-day. Natural Language Processing (NLP) applications can support the work of people responsible for pharmacovigilance. Our objective is to develop NLP algorithms and tools for the detection of ADR clinical terminology. Efficient applications can concretely improve the quality of the experts\u2019 revisions. NLP software can quickly analyze narrative texts and offer an encoding (i.e., a list of MedDRA terms) that the expert has to revise and validate. MagiCoder, an NLP algorithm, is proposed for the automatic encoding of free-text descriptions into MedDRA terms. MagiCoder procedure is efficient in terms of computational complexity. We tested MagiCoder through several experiments. In the first one, we tested it on a large dataset of about 4500 manually revised reports, by performing an automated comparison between human and MagiCoder encoding. Moreover, we tested MagiCoder on a set of about 1800 reports, manually revised ex novo by some experts of the domain, who also compared automatic solutions with the gold reference standard. We also provide two initial experiments with reports written in English, giving a first evidence of the robustness of MagiCoder w.r.t. the change of the language. For the current base version of MagiCoder, we measured an average recall and precision of and , respectively. From a practical point of view, MagiCoder reduces the time required for encoding ADR reports. Pharmacologists have only to review and validate the MedDRA terms proposed by the application, instead of choosing the right terms among the 70\u202fK low level terms of MedDRA. Such improvement in the efficiency of pharmacologists\u2019 work has a relevant impact also on the quality of the subsequent data analysis. We developed MagiCoder for the Italian pharmacovigilance language. However, our proposal is based on a general approach, not depending on the considered language nor the term dictionary

Representing fuzzy information by using XML Schema

Issues related to fuzzy data have been investigated in the classical database research field, and in the last years are becoming interesting topics also in the XML data context. In this work we propose a general XML Schema definition for representing fuzzy information

Defining spatio-temporal granularities for raster data

Proceedings of the 27th International Information Systems Conference, BNCOD 2010info:eu-repo/semantics/publishe

Telemedicine for developing countries: A survey and some design issues

Background Developing countries need telemedicine applications that help in many situations, when physicians are a small number with respect to the population, when specialized physicians are not available, when patients and physicians in rural villages need assistance in the delivery of health care. Moreover, the requirements of telemedicine applications for developing countries are somewhat more demanding than for developed countries. Indeed, further social, organizational, and technical aspects need to be considered for successful telemedicine applications in developing countries. Objective: We consider all the major projects in telemedicine, devoted to developing countries, as described by the proper scientific literature. On the basis of such literature, we want to define a specific taxonomy that allows a proper classification and a fast overview of telemedicine projects in developing countries. Moreover, by considering both the literature and some recent direct experiences, we want to complete such overview by discussing some design issues to be taken into consideration when developing telemedicine software systems. Methods: We considered and reviewed the major conferences and journals in depth, and looked for reports on the telemedicine projects. Results: We provide the reader with a survey of the main projects and systems, from which we derived a taxonomy of features of telemedicine systems for developing countries. We also propose and discuss some classification criteria for design issues, based on the lessons learned in this research area. Conclusions: We highlight some challenges and recommendations to be considered when designing a telemedicine system for developing countries

Design, Development, Deployment of a Telemedicine System in a Developing Country: Dealing with Organizational and Social Issues

Telemedicine means delivering health care services to remote locations by ICT (Information and Communication Technology). Several types of telemedicine systems exist: by this paper, we focus on teleconsulting systems. We report here about a telemedicine project in one of the poorest country worldwide, Burundi. After gathering the requirements, which strongly differ from the requirements of a telemedicine project in a developed country, we designed, implemented, and deployed a prototype aimed at providing local physicians of the Hospital of Ngozi, Burundi, with expert second opinions from their colleagues in the University of Verona, Italy, on interpreting ECG signals, ultrasound and X-ray images. We considered in a seamless way both process- and datarelated requirements. Besides the more technical aspects, we also report on some organizational and social issues we faced during the project

Formal and conceptual modeling of spatio-temporal granularities

In the database research field the management of temporal and spatial information is crucial. Many information may be temporally and spatially qualified, i.e., data may be associated to temporal and spatial locations. In the management of qualified data, the notion of \u201cgranularity\u201d plays an important role; it allows one to reason about temporal and spatial data expressed with different units of measure. By merging together notions of temporal and spatial granularity, in this work we present a formal framework for the representation and management of spatio-temporal granularities. This framework includes relationships and operations between granularities. Moreover, we propose a conceptual design allowing us to represent temporal, spatial, and spatio-temporal granularities in a relational database

Mapping Free Text into MedDRA by Natural Language Processing: A Modular Approach in Designing and Evaluating Software Extensions

MagiCoder is a Natural Language Processing application designed to extract MedDRA terms from narrative clinical text. MagiCoder has been developed to support the work of people responsible for pharmacovigilance. Given a narrative description, MagiCoder proposes an automatic encoding; the pharmacologist reviews, (possibly) corrects, and then validates the solution. This drastically reduces the time needed for the validation of reports with respect to a completely manual encoding. In this paper we extend in a modular way and analyse MagiCoder, comparing its different new extensions. We designed a benchmark consisting of a representative set of adverse drug reaction reports that also includes long and badly written descriptions. We measured an average precision and recall of 68.74% and 70.19%, respectively. On descriptions up to 100 characters, both precision and recall exceeded 75%, i.e., 77.97% and 75.78%, respectively