Decision support system for in-flight emergency events

Medical problems during flight have become an important issue as the number of passengers and miles flown continues to increase. The case of an incident in the plane falls within the scope of the healthcare management in the context of scarce resources associated with isolation of medical actors working in very complex conditions, both in terms of human and material resources. Telemedicine uses information and communication technologies to provide remote and flexible medical services, especially for geographically isolated people. Therefore, telemedicine can generate interesting solutions to the medical problems during flight. Our aim is to build a knowledge-based system able to help health professionals or staff members addressing an urgent situation by given them relevant information, some knowledge, and some judicious advice. In this context, knowledge representation and reasoning can be correctly realized using an ontology that is a representation of concepts, their attributes, and the relationships between them in a particular domain. Particularly, a medical ontology is a formal representation of a vocabulary related to a specific health domain. We propose a new approach to explain the arrangement of different ontological models (task ontology, inference ontology, and domain ontology), which are useful for monitoring remote medical activities and generating required information. These layers of ontologies facilitate the semantic modeling and structuring of health information. The incorporation of existing ontologies [for instance, Systematic Nomenclature Medical Clinical Terms (SNOMED CT)] guarantees improved health concept coverage with experienced knowledge. The proposal comprises conceptual means to generate substantial reasoning and relevant knowledge supporting telemedicine activities during the management of a medical incident and its characterization in the context of air travel. The considered modeling framework is sufficiently generic to cover complex medical situations for isolated and vulnerable populations needing some care and support services

Usage de technologies d'interaction par des personnes âgées atteintes d'une maladie d'Alzheimer

National audienceL'objectif de ce papier est de montrer comment adapter des techniques d'interaction à la souris pour favoriser l’accessibilité des technologies aux personnes atteintes de troubles cognitifs. Le laboratoire de Gérontechnologie du Gérontopôle de Toulouse vise à concevoir des exercices numériques de rééducation cognitive pour des personnes atteintes de la maladie d’Alzheimer. L’efficacité de ces exercices nécessite une Interaction Homme-Machine (IHM) utilisable et efficiente. Pour cela, nous avons réalisé une étude sur trois techniques d’interaction à base de pointage (Clic à clic, Drag and drop et Clic et aimantation). 97 personnes âgées avec (68) ou sans (28) maladie d’Alzheimer mesurée par le MMSE ont été recrutées. Les résultats (extra clic et temps de la tâche) montrent que la technique Clic et aimantation est la plus adaptée aux personnes atteintes de la maladie d’Alzheimer

Particularismes de la recherche technologique au profit des personnes présentant une maladie d'Alzheimer ou un syndrome apparenté

National audienceTechnological research for those suffering Alzheimer disease or related syndromes is different both from regular technological and medical research. We are studying both the user its tool as one only topic. The cognitive disease has an impact on the structure of the study as well as on how the user will interact with the tool. i.e.: it will modify the participation of the user (consent, difficulties to adapt, tiredness...), cause the irruption of the caregivers in the user’s way of life. This com-plex environment requires a multidimensional, multidisciplinary approach framed in a common research goal. The researchers must share an embedded ethical part in their research. The iterative user-centred approach, in our lab, develops in four steps: brain-storming, focus groups, living lab and true-life lab. L’approche itérative centrée utilisateur qui va, pour notre laboratoire, comporter quatre étapes, du plus amont au plus proche de la mise en service : brain-storming, focus groups, living lab puis true-life lab (« vie vraie »).Iterations may imply a compleat step down to the previous step or apply only to a partial hypothesis we could not verify. The true-life lab is a survey of the deployment of the tool in the prospect, uncontroled, use envi-ronment (as opoosed to a controled living lab environment); it will show acceptance and use issues as well as technical robustness. The true-life has four steps: election of the ecosystem, technical deployment, scenario based tests and assessed free use. Success of the true-life lab step will allow clinical trials with the tool.La recherche technologique au profit des personnes présentant une maladie d’Alzheimer ou un syndrome apparenté présente des particularités qui la distinguent tant de la recherche technologique que de la recherche médicale classiques. Le sujet d’étude implique un couple outil, usager ; il doit donc prendre en compte les particularités de la maladie neurodégénérative qui vont avoir une influence tant sur la structuration de l’étude que sur l’interaction entre l’homme et le dispositif. Ces particularités sont les répercussions de la maladie elle-même sur la participation de l’usager (capacité à consentir, trouble de l’adaptation, fatigabilité…) mais également l’intrusion des aidants dans son mode de vie. La prise en compte de cet environnement de recherche complexe implique une approche pluridimensionnelle et multidisciplinaire dans le cadre d’un objectif de recherche. Les acteurs partagent une réflexion éthique continue intégrée au projet. L’approche itérative centrée utilisateur va, pour notre laboratoire, comporter quatre étapes, du plus amont au plus proche de la mise en service : brain-storming, focus groups, living lab puis true-life lab (« vie vraie »). Lors des itérations, un retour complet ou ponctuel aux étapes précédentes pourra être réalisé devant des hypothèses qui ne se seront pas vérifiées. Le true-life lab est le déploiement sous surveillance, dans des conditions d’usage et dans un environnement d’usage qui n’est pas contrôlé (par opposition au living lab) ; il permet de mettre en évidence des éléments d’acceptabilité et d’usage mais également des aspects techniques de robustesse. Le true-life lab se décline en quatre phases : choix de l’écosystème de déploiement, déploiement technique, usage scénarisé et enfin usage libre évalué. Le succès du true-life lab permet le passage à une évaluation clinique

Etude de l'IHR sur deux groupes de personnes agées

International audienceWe used PR2 robot, in autonomous operation in a living lab setting, to provide an object search service to elderly volunteers (familiar to robots or naïve). Observation was complemented by semi-directed interviews. There was no significant difference between the groups either in the successful detection of the willingness to interact or the appreciation of voice interaction. This fosters dedicated HCI development for the elderly.Nous avons étudié l'interaction homme-robot, en fonctionnement autonome en environnement contrôlé, de PR2™ utilisé pour rechercher des objets avec des sujets âgés (avec ou sans expertise robotique). L'observation a été complétée d'entretiens semi-directifs. Il n'y a pas eu de différence significative entre ces deux groupes pour le succès de la détection d'intentionnalité et la perception de l'interaction vocale. Ce résultat est en faveur d'IHM prenant en compte les spécificités de la personne âgée

Preliminary study of human interactions during entertainment by a facilitator using a cognitive stimulation medium (Mémoire-RED) in a nursing-home setting

International audienceAccording to the literature and our practice, most of the cognitive stimulation based on technological tools are designed for individual, « face to face »use and are a transposition of regular neuropsychological tests and rehabilitation exercises (Tarraga et al. 2006). A different approach is proposed to fulfil the needs for entertainment; such as reminding memories with the help of souvenirs of the patients own life. (Damianakis et al. 2010) could show it was possible, first with the help of a research assistant, then with that of the family or even by personal use, to stimulate remembrance through old souvenirs presented on a digital medium.The difficulty is the high cost in term of manpower to get the relevant information from the family. Other teams have proposed solutions that would limit that preliminary work : using data from the social media (Cosley et al. 2009) and/or wearing a camera to save daily activities (Lee and Key, 2007) et (Sellen et al. 2007). In any case, those tools are based upon individual customization and so limiting the number of patients who could attend a same session. Could use general tools developed for entertainment in nursing-home as a cognitive stimulation alternative? In a preliminary study we have observed the adoption of the Mémoire-red™ tool by the facilitator and the interaction with and between the residents during a regular entertainment session with cognitively impaired residents in a nursing-home. This session was part of a structured animation program where the residents regularly take part

Quels sont les objets égarés à domicile par les personnes âgées fragiles ? Une étude pilote sur 60 personnes

National audienceLoosing objects is a cause of conflicts between frail elderlies and their caregivers. To our knowledge, the literature addressing delusion of theft doesn’t provide information on the objects that are involved. In the RIDDLE project, we are using a companion robot to help the elderly find the objects they are looking for. Hence, we initiated a study with the cross interviews of 60 patient/caregiver dyads to identify which objects would be most relevant to them. Objects are looked for by the patient according to 72 % of the patients and 82 % of the caregivers. The most commonly looked for objects, when they are in use by the patient, are: spectacles (45 %), house keys (34 %), mobile (31 %), wallet (26 %), remote control (19 %), and cane (22 %). After rigging the localization technology to the afore-mentioned objects, the related service will have to be customized to the ways of the user.La perte d’objets cause des conflits entre les personnes âgées fragiles et leur famille. Le projet Riddle utilise un robot compagnon pour aider des personnes âgées à retrouver des objets. La bibliographie sur le délire de vol ne donne pas de liste d’objets recherchés. L’objectif est de définir les objets les plus pertinents à localiser en réalisant un interrogatoire croisé, séparément, de 60 couples patient/aidant. Soixante-douze pour cent des patients recherchent des objets (82 % pour les aidants). Les objets utilisés les plus recherchés sont : lunettes (45 %), clés de maison (34 %), téléphone portable (31 %), porte-monnaie (26 %), télécommande (19 %), canne (22 %). Après équipement technique des objets ainsi définis, la mise en œuvre du service d’aide devra tenir compte de l’usage individuel

Discovering frequent patterns for in-flight incidents

Objectives: In order to get a clearer idea of in-flight medical emergencies management, the application of Data mining tools can be useful to facilitate knowledge discovery from data collected by existing studies. The objective of this work is to conceptualize the construction of a Clinical Decision Support System (CDSS) in three stages corresponding to the representation levels necessary to extract knowledge from information and raw data. Method: The method can be summarized in three parts: (1) in-flight medical incident data search, (2) the validation of this data using Data mining tools, (3) the construction of the CDSS in 3 steps corresponding to the levels of knowledge representation. These three steps will be carried out using tools such as EORCA (Event Oriented Representation for Collaborative Activities) which includes action codification with regard to an ontology and event representation. Result: Data processing services provide a good structuration for information about in-flight medical incidents from which useful knowledge can be generated could improve the handling of other incidents by adapting the medical emergency equipments, for example. This structuring can be facilitated by the use of CDSS to fill in any gaps, increase coherency, and provide decision makers with a more complete picture of options that might be involved in a critical situation. Conclusion: We proposed an evolving framework facilitating the description of in-flight medical emergencies with adequate data collection and appropriate information that are required for producing interesting rules and better decisions. The data collected nourishes the organization of information, which can be improved over time by continuous integration of evidence gained from the number of incidents treated. Finally, it is proposed to strengthen requirements concerning the medical equipments available on-board, particularly in the light of knowledge resulting from the selection and approval of interesting rules

Data mining for decision support with uncertainty on the airplane

This study describes the formalization of the medical decision-making process under uncertainty underpinned by conditional preferences, the theory of evidence and the exploitation of high-utility patterns in data mining. To assist a decision maker, the medical process (clinical pathway) was implemented using a Conditional Preferences Base (CPB). Then for knowledge engineering, a Dempster-Shafer ontology integrating uncertainty underpinned by evidence theory was built. Beliefs from different sources are established with the use of data mining. The result is recorded in an In-flight Electronic Health Records (IEHR). The IEHR contains evidential items corresponding to the variables determining the management of medical incidents. Finally, to manage tolerance to uncertainty, a belief fusion algorithm was developed. There is an inherent risk in the practice of medicine that can affect the conditions of medical activities (diagnostic or therapeutic purposes). The management of uncertainty is also an integral part of decision-making processes in the medical field. Different models of medical decisions under uncertainty have been proposed. Much of the current literature on these models pays particular attention to health economics inspired by how to manage uncertainty in economic decisions. However, these models fail to consider the purely medical aspect of the decision that always remains poorly characterized. Besides, the models achieving interesting decision outcomes are those considering the patient's health variable and other variables such as the costs associated with the care services. These models are aimed at defining health policy (health economics) without a deep consideration for the uncertainty surrounding the medical practices and associated technologies. Our approach is to integrate the management of uncertainty into clinical reasoning models such as Clinical Pathway and to exploit the relationships between the determinants of incident management using data mining tools. To this end, how healthcare professionals see and conceive uncertainty has been investigated. This allowed for the identification of the characteristics determining people under uncertainty and to understand the different forms and representations of uncertainty. Furthermore, what an in-flight medical incident is and how its management is a decision under uncertainty issues was defined. This is the first phase of common data mining that will provide an evidential transaction basis. Subsequently an evidential and ontological rea-soning to manage this uncertainty has been established in order to support decision making processes on the airplane

A multi-modal perception based assistive robotic system for the elderly

Edited by Giovanni Maria Farinella, Takeo Kanade, Marco Leo, Gerard G. Medioni, Mohan TrivediInternational audienceIn this paper, we present a multi-modal perception based framework to realize a non-intrusive domestic assistive robotic system. It is non-intrusive in that it only starts interaction with a user when it detects the user's intention to do so. All the robot's actions are based on multi-modal perceptions which include user detection based on RGB-D data, user's intention-for-interaction detection with RGB-D and audio data, and communication via user distance mediated speech recognition. The utilization of multi-modal cues in different parts of the robotic activity paves the way to successful robotic runs (94% success rate). Each presented perceptual component is systematically evaluated using appropriate dataset and evaluation metrics. Finally the complete system is fully integrated on the PR2 robotic platform and validated through system sanity check runs and user studies with the help of 17 volunteer elderly participants

Déploiement et expérimentation d'un système socio-technique pour la surveillance des activités comportementales de personnes en perte d'autonomie dans un habitat intelligent

National audienceHome maintenance is a response to the care of people with loss of autonomy. The technology is now mature enough to support these people in their aging home. SUIPAD project attempts to assess the contribution and impact of some technologies for the automatic collection of data for environmental and physiological knowledge of events, activities and attitudes that characterize the actual behavior of frail people in their ordinary living environment.Le maintien à domicile est un élément de réponse à la prise en charge des personnes en perte d’autonomie. La technologie est aujourd’hui suffisamment mûre pour accompagner ces personnes dans leur vieillissement chez elles. Le projet SUIPAD tente d’évaluer l’apport et l’impact de certaines technologies pour le recueil automatique de données ambiantes et physiologiques permettant une bonne connaissance des évènements, des activités et attitudes qui caractérisent le comportement réel de personnes fragiles dans leur environnement de vie ordinaire