Indexing the Event Calculus with Kd-trees to Monitor Diabetes

Personal Health Systems (PHS) are mobile solutions tailored to monitoring patients affected by chronic non communicable diseases. A patient affected by a chronic disease can generate large amounts of events. Type 1 Diabetic patients generate several glucose events per day, ranging from at least 6 events per day (under normal monitoring) to 288 per day when wearing a continuous glucose monitor (CGM) that samples the blood every 5 minutes for several days. This is a large number of events to monitor for medical doctors, in particular when considering that they may have to take decisions concerning adjusting the treatment, which may impact the life of the patients for a long time. Given the need to analyse such a large stream of data, doctors need a simple approach towards physiological time series that allows them to promptly transfer their knowledge into queries to identify interesting patterns in the data. Achieving this with current technology is not an easy task, as on one hand it cannot be expected that medical doctors have the technical knowledge to query databases and on the other hand these time series include thousands of events, which requires to re-think the way data is indexed. In order to tackle the knowledge representation and efficiency problem, this contribution presents the kd-tree cached event calculus (\ceckd) an event calculus extension for knowledge engineering of temporal rules capable to handle many thousands events produced by a diabetic patient. \ceckd\ is built as a support to a graphical interface to represent monitoring rules for diabetes type 1. In addition, the paper evaluates the \ceckd\ with respect to the cached event calculus (CEC) to show how indexing events using kd-trees improves scalability with respect to the current state of the art.Comment: 24 pages, preliminary results calculated on an implementation of CECKD, precursor to Journal paper being submitted in 2017, with further indexing and results possibilities, put here for reference and chronological purposes to remember how the idea evolve

Knowledge sharing in the health scenario

The understanding of certain data often requires the collection of similar data from different places to be analysed and interpreted. Interoperability standards and ontologies, are facilitating data interchange around the world. However, beyond the existing networks and advances for data transfer, data sharing protocols to support multilateral agreements are useful to exploit the knowledge of distributed Data Warehouses. The access to a certain data set in a federated Data Warehouse may be constrained by the requirement to deliver another specific data set. When bilateral agreements between two nodes of a network are not enough to solve the constraints for accessing to a certain data set, multilateral agreements for data exchange are needed. We present the implementation of a Multi-Agent System for multilateral exchange agreements of clinical data, and evaluate how those multilateral agreements increase the percentage of data collected by a single node from the total amount of data available in the network. Different strategies to reduce the number of messages needed to achieve an agreement are also considered. The results show that with this collaborative sharing scenario the percentage of data collected dramaticaly improve from bilateral agreements to multilateral ones, up to reach almost all data available in the network.Peer ReviewedPostprint (published version

Processing Diabetes mellitus composite events in MAGPIE

The focus of this research is in the definition of programmable expert Personal Health Systems (PHS) to monitor patients affected by chronic diseases using agent oriented programming and mobile computing to represent the interactions happening amongst the components of the system. The paper also discusses issues of knowledge representation within the medical domain when dealing with temporal patterns concerning the physiological values of the patient. In the presented agent based PHS the doctors can personalize for each patient monitoring rules that can be defined in a graphical way. Furthermore, to achieve better scalability, the computations for monitoring the patients are distributed among their devices rather than being performed in a centralized server. The system is evaluated using data of 21 diabetic patients to detect temporal patterns according to a set of monitoring rules defined. The system’s scalability is evaluated by comparing it with a centralized approach. The evaluation concerning the detection of temporal patterns highlights the system’s ability to monitor chronic patients affected by diabetes. Regarding the scalability, the results show the fact that an approach exploiting the use of mobile computing is more scalable than a centralized approach. Therefore, more likely to satisfy the needs of next generation PHSs. PHSs are becoming an adopted technology to deal with the surge of patients affected by chronic illnesses. This paper discusses architectural choices to make an agent based PHS more scalable by using a distributed mobile computing approach. It also discusses how to model the medical knowledge in the PHS in such a way that it is modifiable at run time. The evaluation highlights the necessity of distributing the reasoning to the mobile part of the system and that modifiable rules are able to deal with the change in lifestyle of the patients affected by chronic illnesses.Peer ReviewedPostprint (author's final draft

Providing interoperability to a pervasive healthcare system through the HL7 CDA Standard

Background: Pervasive healthcare is a new paradigm of healthcare services where the patients are active participants on their own well being. The development of Pervasive Healthcare Systems (PHSs) consists on approaching monitoring solutions into the hands of the patients, and has been reported as a key to minimize the healthcare costs due to the aging of population. However, interoperability is a technological challenge not taken into account in most of the existing implementations of PHSs. Objectives: This paper focuses on how we provide interoperability to a PHS for the management of the gestational diabetes mellitus (GDM) by using the CDA standard. In this monitoring system an Android application sends CDA documents to the server side of the system, so that the health information reported by the patient is transmitted over the Internet in an interoperable way

Security analysis of a protocol based on multiagents systems for clinical data exchange

This work describes the security architecture of MOSAIC, a protocol for clinical data exchange with multilateral agreement support. The blocks of the architecture are derived from a series of common attacks that can be done to the protocol. The fair exchange problem of the protocol is analyzed introducing the management messages that the agents must exchange in order to authorize or not the use of data. Due to multilateral agreements, loops can appear in the negotiation stage of the protocol. We describe the mechanisms to manage this loops, and we propose a solution to avoid that malicious agents can take advantage when there is a loop in the negotiation stage of the protocol.Peer Reviewe

Current trends in interoperability, scalability and security of pervasive healthcare systems

The development of pervasive healthcare systems consist on applying the ubiquitous computing in the healthcare context. The systems developed in this research field have the goals of offering better healthcare services, promoting well-being of the people and assist healthcare professionals in their tasks. The aim of the present work is to give an overview of the main research efforts in the area of pervasive healthcare systems, and to identify which are the main research challenges in this topic of research. Furthermore, we review the current state of the art for these kind of systems with respect some of the research challenges identified. In particular we focus on contributions done into interoperability, scalability and security of these systems

Security analysis of a protocol based on multiagents systems for clinical data exchange

This work describes the security architecture of MOSAIC, a protocol for clinical data exchange with multilateral agreement support. The blocks of the architecture are derived from a series of common attacks that can be done to the protocol. The fair exchange problem of the protocol is analyzed introducing the management messages that the agents must exchange in order to authorize or not the use of data. Due to multilateral agreements, loops can appear in the negotiation stage of the protocol. We describe the mechanisms to manage this loops, and we propose a solution to avoid that malicious agents can take advantage when there is a loop in the negotiation stage of the protocol.Peer Reviewe

Knowledge sharing in the health scenario

The understanding of certain data often requires the collection of similar data from different places to be analysed and interpreted. Interoperability standards and ontologies, are facilitating data interchange around the world. However, beyond the existing networks and advances for data transfer, data sharing protocols to support multilateral agreements are useful to exploit the knowledge of distributed Data Warehouses. The access to a certain data set in a federated Data Warehouse may be constrained by the requirement to deliver another specific data set. When bilateral agreements between two nodes of a network are not enough to solve the constraints for accessing to a certain data set, multilateral agreements for data exchange are needed. We present the implementation of a Multi-Agent System for multilateral exchange agreements of clinical data, and evaluate how those multilateral agreements increase the percentage of data collected by a single node from the total amount of data available in the network. Different strategies to reduce the number of messages needed to achieve an agreement are also considered. The results show that with this collaborative sharing scenario the percentage of data collected dramaticaly improve from bilateral agreements to multilateral ones, up to reach almost all data available in the network.Peer Reviewe

Processing Diabetes mellitus composite events in MAGPIE

The focus of this research is in the definition of programmable expert Personal Health Systems (PHS) to monitor patients affected by chronic diseases using agent oriented programming and mobile computing to represent the interactions happening amongst the components of the system. The paper also discusses issues of knowledge representation within the medical domain when dealing with temporal patterns concerning the physiological values of the patient. In the presented agent based PHS the doctors can personalize for each patient monitoring rules that can be defined in a graphical way. Furthermore, to achieve better scalability, the computations for monitoring the patients are distributed among their devices rather than being performed in a centralized server. The system is evaluated using data of 21 diabetic patients to detect temporal patterns according to a set of monitoring rules defined. The system’s scalability is evaluated by comparing it with a centralized approach. The evaluation concerning the detection of temporal patterns highlights the system’s ability to monitor chronic patients affected by diabetes. Regarding the scalability, the results show the fact that an approach exploiting the use of mobile computing is more scalable than a centralized approach. Therefore, more likely to satisfy the needs of next generation PHSs. PHSs are becoming an adopted technology to deal with the surge of patients affected by chronic illnesses. This paper discusses architectural choices to make an agent based PHS more scalable by using a distributed mobile computing approach. It also discusses how to model the medical knowledge in the PHS in such a way that it is modifiable at run time. The evaluation highlights the necessity of distributing the reasoning to the mobile part of the system and that modifiable rules are able to deal with the change in lifestyle of the patients affected by chronic illnesses.Peer Reviewe