Patient-based Literature Retrieval and Integration: A Use Case for Diabetes and arterial Hypertension

Specialized search engines such as PubMed, MedScape or Cochrane have increased dramatically the visibility of biomedical scientific results. These web-based tools allow physicians to access scientific papers instantly. However, this decisive improvement had not a proportional impact in clinical practice due to the lack of advanced search methods. Even queries highly specified for a concrete pathology frequently retrieve too many information, with publications related to patients treated by the physician beyond the scope of the results examined. In this work we present a new method to improve scientific article search using patient information. Two pathologies have been used within the project to retrieve relevant literature to patient data and to be integrated with other sources. Promising results suggest the suitability of the approach, highlighting publications dealing with patient features and facilitating literature search to physicians.

Parallel workflows to personalize clinical guidelines recommendations: application to gestational diabetes mellitus

The MobiGuide system provides patients with personalized decision support tools, based on computerized clinical guidelines, in a mobile environment. The generic capabilities of the system will be demonstrated applied to the clinical domain of Gestational Diabetes (GD). This paper presents a methodology to identify personalized recommendations, obtained from the analysis of the GD guideline. We added a conceptual parallel part to the formalization of the GD guideline called "parallel workflow" that allows considering patient?s personal context and preferences. As a result of analysing the GD guideline and eliciting medical knowledge, we identified three different types of personalized advices (therapy, measurements and upcoming events) that will be implemented to perform patients? guiding at home, supported by the MobiGuide system. These results will be essential to determine the distribution of functionalities between mobile and server decision support capabilities.

Automatic blood glucose classification for gestational diabetes with feature selection: decision trees vs neural networks

Automatic blood glucose classification may help specialists to provide a better interpretation of blood glucose data, downloaded directly from patients glucose meter and will contribute in the development of decision support systems for gestational diabetes. This paper presents an automatic blood glucose classifier for gestational diabetes that compares 6 different feature selection methods for two machine learning algorithms: neural networks and decision trees. Three searching algorithms, Greedy, Best First and Genetic, were combined with two different evaluators, CSF and Wrapper, for the feature selection. The study has been made with 6080 blood glucose measurements from 25 patients. Decision trees with a feature set selected with the Wrapper evaluator and the Best first search algorithm obtained the best accuracy: 95.92%.

Exercise during pregnancy and gestational diabetes related adverse effects: a randomized controlled trial

Ejercicio, embarazo y diabetes

Exercise-based intervention to prevent excessive gestational

El ejercicio en el embarazo.

Could excessive gestational weight gain be prevented by exercise?

La ganancia de peso en el embarazo puede prevenirse mediante un programa de ejercicio físico.

Patient-oriented computerized clinical guidelines for mobile decision support in gestational diabetes

The risks associated with gestational diabetes (GD) can be reduced with an active treatment able to improve glycemic control. Advances in mobile health can provide new patient-centric models for GD to create personalized health care services, increase patient independence and improve patients’ self-management capabilities, and potentially improve their treatment compliance. In these models, decision-support functions play an essential role. The telemedicine system MobiGuide provides personalized medical decision support for GD patients that is based on computerized clinical guidelines and adapted to a mobile environment. The patient’s access to the system is supported by a smartphone-based application that enhances the efficiency and ease of use of the system. We formalized the GD guideline into a computer-interpretable guideline (CIG). We identified several workflows that provide decision-support functionalities to patients and 4 types of personalized advice to be delivered through a mobile application at home, which is a preliminary step to providing decision-support tools in a telemedicine system: (1) therapy, to help patients to comply with medical prescriptions; (2) monitoring, to help patients to comply with monitoring instructions; (3) clinical assessment, to inform patients about their health conditions; and (4) upcoming events, to deal with patients’ personal context or special events. The whole process to specify patient-oriented decision support functionalities ensures that it is based on the knowledge contained in the GD clinical guideline and thus follows evidence-based recommendations but at the same time is patient-oriented, which could enhance clinical outcomes and patients’ acceptance of the whole system.

Design evaluation of a prototype user interface to support a guideline-based decision support system in gestational diabetes

Gestational Diabetes (GD) has increased over the last 20 years, affecting up to 15% of pregnant women worldwide. The complications associated can be reduced with the appropriate glycemic control during the pregnancy.