349 research outputs found

    Implementation of workflow engine technology to deliver basic clinical decision support functionality

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    BACKGROUND: Workflow engine technology represents a new class of software with the ability to graphically model step-based knowledge. We present application of this novel technology to the domain of clinical decision support. Successful implementation of decision support within an electronic health record (EHR) remains an unsolved research challenge. Previous research efforts were mostly based on healthcare-specific representation standards and execution engines and did not reach wide adoption. We focus on two challenges in decision support systems: the ability to test decision logic on retrospective data prior prospective deployment and the challenge of user-friendly representation of clinical logic. RESULTS: We present our implementation of a workflow engine technology that addresses the two above-described challenges in delivering clinical decision support. Our system is based on a cross-industry standard of XML (extensible markup language) process definition language (XPDL). The core components of the system are a workflow editor for modeling clinical scenarios and a workflow engine for execution of those scenarios. We demonstrate, with an open-source and publicly available workflow suite, that clinical decision support logic can be executed on retrospective data. The same flowchart-based representation can also function in a prospective mode where the system can be integrated with an EHR system and respond to real-time clinical events. We limit the scope of our implementation to decision support content generation (which can be EHR system vendor independent). We do not focus on supporting complex decision support content delivery mechanisms due to lack of standardization of EHR systems in this area. We present results of our evaluation of the flowchart-based graphical notation as well as architectural evaluation of our implementation using an established evaluation framework for clinical decision support architecture. CONCLUSIONS: We describe an implementation of a free workflow technology software suite (available at http://code.google.com/p/healthflow) and its application in the domain of clinical decision support. Our implementation seamlessly supports clinical logic testing on retrospective data and offers a user-friendly knowledge representation paradigm. With the presented software implementation, we demonstrate that workflow engine technology can provide a decision support platform which evaluates well against an established clinical decision support architecture evaluation framework. Due to cross-industry usage of workflow engine technology, we can expect significant future functionality enhancements that will further improve the technology's capacity to serve as a clinical decision support platform

    Conceptual knowledge acquisition in biomedicine: A methodological review

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    AbstractThe use of conceptual knowledge collections or structures within the biomedical domain is pervasive, spanning a variety of applications including controlled terminologies, semantic networks, ontologies, and database schemas. A number of theoretical constructs and practical methods or techniques support the development and evaluation of conceptual knowledge collections. This review will provide an overview of the current state of knowledge concerning conceptual knowledge acquisition, drawing from multiple contributing academic disciplines such as biomedicine, computer science, cognitive science, education, linguistics, semiotics, and psychology. In addition, multiple taxonomic approaches to the description and selection of conceptual knowledge acquisition and evaluation techniques will be proposed in order to partially address the apparent fragmentation of the current literature concerning this domain

    L’émergence de moyens grammaticaux pour exprimer les relations temporelles en L2

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    Cet article se focalise sur la transition entre l’expression lexicale et l’expression grammaticale des relations temporelles, en discutant les résultats de recherches récentes basées sur une partie des données ESF, notamment en français et en néerlandais L2. Les données prises en compte révèlent deux parcours acquisitionnels à première vue très différents : en néerlandais L2 (apprenants turcs et marocains) l’émergence d’une morphologie verbale fonctionnelle conduit à une étape intermédiaire caractérisée par la combinaison de deux morphèmes libres qui encodent séparément les valeurs de temps/aspect ; en français L2 (apprenants hispanophones), les premières formes d’auxiliaire semblent avoir une valeur temporelle, alors que certaines distinctions aspectuelles sont exprimées par l’adverbe de contraste temporel déjà. Nous suggérons que les deux parcours reflètent une tendance dévelop­pementale commune, spécifique à l’apprenant, à traiter séparément les valeurs complexes de la flexion verbale : les composantes temporelle et aspectuelle seraient encodées d’abord de manière analytique — soit par deux morphèmes libres, soit par une forme verbale associée à un marqueur lexical spécialisé — avant de pouvoir fusionner dans la morphologie verbale.This article focuses on the transition between lexical and grammatical expression of temporal relations, by discussing the results of recent research based on some of the ESF project, namely French and Dutch L2.Learner production reveals two acquisitional paths which are apparently very different : in Dutch L2 (Turkish and Moroccan Arabic learners) the emergence of a functional verb morphology leads to an intermediary stage where a combination of two free morphemes encodes separately tense and aspect oppositions ; in French L2 (Spanish-speaking learners), the first auxiliaries seem to have a temporal value, whereas some aspectual distinctions are expressed by the adverb of temporal contrast déjà.We suggest that both acquisitional paths can be accounted for by a learner-specific common tendency to deal separately with the complex values of verb inflection : the temporal and aspectual components would be encoded first in an analytic way – either by two free morphemes or by a verb form combined with a specialized lexical marker — before being packaged into one verbal form

    Acquisition du marquage du progressif par des apprenants germanophones de l’italien et neerlandophones du français

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    Les concepts temporo-aspectuels permettent aux locuteurs d’envisager un événement comme ayant atteint son terme (perfectif), ou non (imperfectif), ou encore de le présenter explicitement en déroulement. Le concept du progressif est grammaticalisé à différents degrés selon les langues, et l’italien, le néerlandais et le français offrent un intérêt particulier en L2 dans la mesure où des traits sémantiques temporels entraînent ou excluent le recours à cet aspect. La question alors est de voir si des apprenants adultes d’une langue comme l’italien ou le français ont su découvrir les principes qui guident l’usage de l’aspect progressif à partir d’un input linguistique particulièrement complexe. L’utilisation du progressif en néerlandais et en français fonctionne globalement selon les mêmes critères temporels, mais les apprenants sont confrontés à des affinités plus ou moins prononcées selon les domaines sémantiques. Le problème n’est pas le même en allemand où le recours au progressif est particulièrement rare. L’analyse des variétés d’apprenants ouvre de nouvelles perspectives dans la mise en évidence de facteurs liés à des phénomènes de transfert en L2, mais aussi à l’utilisation du progressif.When talking about events, temporal-aspectual concepts allow speakers to say whether an event has reached a point of completion (perfective), or is not completed (im-perfective), or is still in progress in explicit terms (progressive aspect). The present study is based on a series of cross-linguistic analyses on the factors that warrant or exclude use of progressive aspect in languages in which the distinction is not fully grammaticalized – as in Modern Standard Arabic, Dutch, French, Italian. The nature of the underlying factors is represented in terms of (i) temporal properties of situations as well as (2) the types of verbs (1-time versus 2-times) implemented in mapping this concept into form. The languages in question pose an interesting case for the study of second language acquisition since Italian and Dutch show evidence of a gradual loss of selectional restrictions, compared to German and French. While all of the languages mentioned share a similar set of underlying temporal principles in determining conceptualization of this aspectual distinction, German learners of Italian and Dutch learners of French are confronted with differences in frequency of use across the relevant situation types, compared to their L1. The question is : are second language learners at an intermediate stage of acquisition sensitive to differences of this nature ? The analyses of the learner languages provide further insight into questions related to transfer in L2 acquisition as well as progressive aspect
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