Sven Van Laere

A Method for Detecting Behavior-Based User Profiles in Collaborative Ontology Engineering

Ontology engineering is far from trivial and most collaborative methods and tools start from a predefined set of rules, stakeholders can have in the ontology engineering process. We, however, believe that the different types of user behavior are not known a priori and depend on the ontology engineering project. The detection of such user profiles based on unsupervised learning allows finding roles and responsibilities along peers in a collaborative setting. In this paper, we present a method for automatic detection of user profiles in a collaborative ontology engineering environment by means of the K-means clustering algorithm only by looking at the type of interactions a user makes. In this paper we use the GOSPL ontology engineering tool and method to demonstrate this method. The data used to demonstrate the method stems from two ontology engineering projects involving respectively 42 and 36 users.

Using Togaf for Building a National Implementation Strategy for E-Health Services and Technologies in Burundi

In order to better align existing and future ICT implementations in the health domain with the strategic options defined by the National Plan for Health Development, the Ministry of Health (MoH) of Burundi initiated in 2014 the development of a national e-health enterprise architecture based on the TOGAF methodology. A first part of the development cycle consisted of a detailed analysis of regulatory documents and strategic plans related to the Burundian health system. In a second part, semi-structured interviews were organized with a representative sample of relevant MoH health structures. The study demonstrated the donor driven unequal distribution of hardware equipment over health administration components and health facilities. Internet connectivity remains problematic and few health oriented business applications found their way to the Burundian health system. Paper based instruments remain predominant in Burundi’s health administration. The study also identified a series of problems introduced by the uncoordinated development of health ICT in Burundi such as the lack of standardization, data security risks, varying data quality, inadequate ICT infrastructures, an unregulated e-health sector and insufficient human capacity. The results confirm the challenging situation of the Burundian health information system but they also expose a number of bright spots that provide hope for the future: a political will to reclaim MoH leadership in the health information management domain, the readiness to develop e-health education and training programs and the opportunity to capitalize the experiences with DHIS2 deployment, results based financing monitoring and hospital information management systems implementation.

The Quality of EBM Sources Perceived By Belgian Family Physicians

BACKGROUND: Belgian family physicians use several local and international sources for evidence-based medicine (EBM). AIM: This study aims to investigate the quality of these EBM sources according to the Belgian family physicians. METHODS: A sample of Belgian family physicians completed a digital survey on the quality of EBM sources. RESULTS: Respondents evaluated the quality of the information for the major part of the local and international EBM sources good to excellent. More than 50% of the respondents found in the major part of the sources an answer to the question. More than half of the respondents found the necessary information in less than 5 minutes in most of the sources. Younger participants self-evaluated their search skills better than older participants. CONCLUSION: The quality of most frequently used EBM sources in Belgium is evaluated as good and client-friendly. More than half of the respondents found an answer to their questions in most of the sources and this within 5 minutes.

Short-Term Results after Total Trapeziectomy with a Poly-L/D-Lactide Spacer

Background Proximal migration of the first metacarpal can be seen after total trapeziectomy and various techniques have been described to prevent this subsidence. Purpose We hypothesized the insertion of a poly‐L/D‐lactide spacer to prevent proximal migration of the first metacarpal without the need of an additional ligament reconstruction, allowing early mobilization and less demanding rehabilitation. Patients and Methods Ten thumbs were treated with a total trapeziectomy and insertion of a poly‐L/D‐lactide scaffold. Clinical and radiological evaluation was performed after 6 months and 1 year. Patient satisfaction, pain, Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, mobility of the thumb, and strength were assessed. Results Pain according to the visual analog scale decreased (p = 0.01) and QuickDASH score decreased (p = 0.02) significantly after 1 year. Radiological evaluation after 12 months showed a collapse of the scaphometacarpal distance of 45% (p = 0.01). Osteolysis of the distal scaphoid pole and/or proximal metacarpal was seen in 6 out of 10 cases. Because of the osteolysis, the use of the poly‐L/D‐lactide scaffold was discontinued in our practice. Conclusion In this limited series, total trapeziectomy with the use of the poly‐L/D‐lactide scaffold provides significant pain reduction and improvement of overall function. Radiographic evaluation shows significant collapse of the scaphometacarpal distance after 1 year and frequent signs of osteolysis. We do not encourage the use of the poly‐L/D‐lactide scaffold with total trapeziectomy before long‐term clinical and radiological follow‐ups of the osteolysis are available.

Clinical Decision Support Systems for Drug Allergy Checking: Systematic Review

Background Worldwide, the burden of allergies—in particular, drug allergies—is growing. In the process of prescribing, dispensing, or administering a drug, a medication error may occur and can have adverse consequences; for example, a drug may be given to a patient with a documented allergy to that particular drug. Computerized physician order entry (CPOE) systems with built-in clinical decision support systems (CDSS) have the potential to prevent such medication errors and adverse events. Objective The aim of this review is to provide a comprehensive overview regarding all aspects of CDSS for drug allergy, including documenting, coding, rule bases, alerts and alert fatigue, and outcome evaluation. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed as much as possible and searches were conducted in 5 databases using CPOE, CDSS, alerts, and allergic or allergy as keywords. Bias could not be evaluated according to PRISMA guidelines due to the heterogeneity of study types included in the review. Results Of the 3160 articles considered, 60 met the inclusion criteria. A further 9 articles were added based on expert opinion, resulting in a total of 69 articles. An interrater agreement of 90.9% with a reliability Κ=.787 (95% CI 0.686-0.888) was reached. Large heterogeneity across study objectives, study designs, study populations, and reported results was found. Several key findings were identified. Evidence of the usefulness of clinical decision support for drug allergies has been documented. Nevertheless, there are some important problems associated with their use. Accurate and structured documenting of information on drug allergies in electronic health records (EHRs) is difficult, as it is often not clear to healthcare providers how and where to document drug allergies. Besides the underreporting of drug allergies, outdated or inaccurate drug allergy information in EHRs poses an important problem. Research on the use of coding terminologies for documenting drug allergies is sparse. There is no generally accepted standard terminology for structured documentation of allergy information. The final key finding is the consistently reported low specificity of drug allergy alerts. Current systems have high alert override rates of up to 90%, leading to alert fatigue. Important challenges remain for increasing the specificity of drug allergy alerts. We found only one study specifically reporting outcomes related to CDSS for drug allergies. It showed that adverse drug events resulting from overridden drug allergy alerts do not occur frequently. Conclusions Accurate and comprehensive recording of drug allergies is required for good use of CDSS for drug allergy screening. We found considerable variation in the way drug allergy are recorded in EHRs. It remains difficult to reduce drug allergy alert overload while maintaining patient safety as the highest priority. Future research should focus on improving alert specificity, thereby reducing override rates and alert fatigue. Also, the effect on patient outcomes and cost-effectiveness should be evaluated.

Detecting User Profiles in Collaborative Ontology Engineering Using a User’s Interactions

Collaborative ontology-engineering methods usually prescribe a set of processes, activities, stakeholders, and the roles each stakeholder plays in these activities. We, however, believe that (a) the stakeholder community of each ontology-engineering project is different, and (b) one can observe different types of user behavior. It may thus very well be that the prescribed set of stakeholder types and roles do not suffice. If one were able to identify these user behavior types, which we will call user profiles, one can compliment or revisit those predefined roles. For instance, those user profiles can be used to provide customized interfaces for optimizing activities in certain ontology-engineering projects. We present a method for discovering different user profiles based on the interactions users have with each other on a collaborative ontology-engineering environment. Our approach clusters users based on the types of interactions they perform, which are retrieved from datasets that were annotated with an interaction ontology—built on top of SIOC—that we have developed. We demonstrate our method using the database of two instances of the GOSPL ontology-engineering tool. The databases contain the interactions of two distinct ontology-engineering projects involving, respectively, 42 and 36 users. For each dataset, we discuss the findings by analyzing the different clusters. We found that we are able to discover different user profiles, indicating that the approach we have taken is viable, though more experiments are needed to validate the results and to discover patterns across ontology-engineering projects.

An Architecture for Electronic Prescribing in Physiotherapy in Belgium

This paper describes the architecture designed for the introduction of the electronic physiotherapy prescription in Belgium. Based on the model for the ambulatory medication prescription, which is currently in a national roll-out phase, we constructed a model that takes into account the particularities of the physiotherapy domain as well as all legal regulations. We focus on key components of the project: the technical building blocks and the prescription content. We illustrate the data-flow and use-case with two specific examples comprising both the normal physiotherapy prescribing situation as well as more complex situations where missing information are dealt with. Furthermore, we elaborate on the implementation and patient involvement.

Building а National Clinical Data Warehouse

Turkey has created an e-health vision along with the Health Transformation Program. In this framework, standard coding systems such as standard definitions of the institutions, databank of healthcare providers, standard disease, drug and medical supplies classifications have been developed and a national clinical data warehouse (Health-NET) was established. Health-NET is an integrated, safe, fast and expandable health information system which aims to improve efficiency and quality of health services by collecting all kinds of data produced in the health institutions in line with the standards and generating information adequate for all stakeholders of the collected data.

The Application of PEST Analysis to the Creation of the Profile of na IT Product Designed to Activate and Support Senior Citizens in Poland

The purpose of the paper is to create a profile of an IT product, using IT tools to collect and to analyse information and enable communication between elderly people to support and activate them. PEST Analysis method was used to determine different factors of influence on the domain of elderly people activation and support Having evaluated the factors and defined the product characteristics, the Authors focused on defining the profile of the IT product by referring the aforementioned characteristics to the structure of the product in the marketing understanding thereof.

Interoperability Within E-Health Arena

Integrated care that starts with patients taking care for their health, that includes truly multidisciplinary team approach to treating patients’ conditions and that utilizes enormous existing common knowledge in an efficient way, is one big step towards increasing healthcare provisioning quality while in the same time having healthcare cost under control. The foundation of the integrated care is timely availability of comprehensive information for all stakeholders within healthcare processes independent on their location and information system or application they use. The absolute precondition for this is ability of different IT systems / applications to exchange and display information in a way that is not only comprehensible to all stakeholders but also means the same to all of them. This ability is called interoperability. In this paper, overview of different interoperability aspects for electronic healthcare records / personal healthcare records is given. The main standards / initiatives are explained along with some challenges and possible way forward. Index Terms — Electronic Healthcare Record, Personal Healthcare Record, interoperability EN 13606, openEHR, archetype, HL7 CDA, IHE