Group decision making and Quality-of-information in e-Health systems

Knowledge is central to the modern economy and society. Indeed, the knowledge society has transformed the concept of knowledge and is more and more aware of the need to overcome the lack of knowledge when has to make options or address its problems and dilemmas. One’s knowledge is less based on exact facts and more on hypotheses, perceptions or indications. Even when we use new computational artefacts and novel methodologies for problem solving, like the use of Group Decision Support Systems (GDSSs), the question of incomplete information is in most of the situations marginalized. On the other hand, common sense tells us that when a decision is made it is impossible to have a perception of all the information involved and the nature of its intrinsic quality. Therefore, something has to be made in terms of the information available and the process of its evaluation. It is under this framework that a Multi-valued Extended Logic Programming language will be used for knowledge representation and reasoning, leading to a model that embodies the Quality-of-Information (QoI) and its quantification, along the several stages of the decision-making process. In this way, it is possible to provide a measure of the value of the QoI that supports the decision itself. This model will be here presented in the context of a GDSS for VirtualECare, a system aimed at sustaining online healthcare services.

VirtualECare: group support in collaborative networks organizations for digital homecare

Collaborative Work plays an important role in today’s organizations, especially in areas where decisions must be made. However, any decision that involves a collective or group of decision makers is, by itself complex, but is becoming recurrent in recent years. In this work we present the VirtualECare project, an intelligent multi-agent system able to monitor, interact and serve its customers, which are, normally, in need of care services. In last year’s there has been a substantially increase on the number of people needed of intensive care, especially among the elderly, a phenomenon that is related to population ageing. However, this is becoming not exclusive of the elderly, as diseases like obesity, diabetes and blood pressure have been increasing among young adults. This is a new reality that needs to be dealt by the health sector, particularly by the public one. Given this scenarios, the importance of finding new and cost effective ways for health care delivery are of particular importance, especially when we believe they should not to be removed from their natural “habitat”. Following this line of thinking, the VirtualECare project will be presented, like similar ones that preceded it. Recently we have also assisted to a growing interest in combining the advances in information society - computing, telecommunications and presentation – in order to create Group Decision Support Systems (GDSS). Indeed, the new economy, along with increased competition in today’s complex business environments, takes the companies to seek complementarities in order to increase competitiveness and reduce risks. Under these scenarios, planning takes a major role in a company life. However, effective planning depends on the generation and analysis of ideas (innovative or not) and, as a result, the idea generation and management processes are crucial. Our objective is to apply the above presented GDSS to a new area. We believe that the use of GDSS in the healthcare arena will allow professionals to achieve better results in the analysis of one’s Electronically Clinical Profile (ECP). This achievement is vital, regarding the explosion of knowledge and skills, together with the need to use limited resources and get better results.

Avaliação de realce tardio do miocárdio por tomografia computorizada

A distinção entre miocárdio atordoado e danificado tem sido uma preocupação relevante, no cenário de um enfarte agudo do miocárdio (EAM). A avaliação da viabilidade do miocárdio, pós-enfarte, é de importância vital, no contexto clínico, principalmente numa fase inicial. Actualmente a Ressonância Magnética Cardíaca é o exame de referência para a avaliação de viabilidade do miocárdio. No entanto, é um exame com elevado custo e de difícil acesso. Estudos preliminares demonstraram potencial na utilização de imagens por Tomografia Computorizada para avaliação da área de enfarte, quer em estudos animais quer em humanos. É objectivo desta tese verificar a utilidade de um protocolo de avaliação de viabilidade do miocárdio, com base em imagens de realce tardio (RT) por Tomografia Computorizada, após um procedimento de intervenção coronária percutânea, no contexto de enfarte agudo do miocárdio com elevação do segmento ST (STEMI). Pretende-se igualmente contribuir para a análise da imagem médica do miocárdio, proporcionando métodos de quantificação do RT e software de suporte à decisão médica nesta modalidade de imagem substancialmente recente. São avaliados vários processos para a quantificação do volume de RT, incluindo um método inovador baseado na detecção automática do miocárdio normal. _E ainda proposto um algoritmo para detecção automática do grau de transmuralidade, por segmento do miocárdio, e comparado o seu grau de eficiência face ao diagnóstico médico dos mesmos exames. Apesar do reduzido número de exames utilizado para validação das técnicas descritas nesta tese, os resultados são bastante promissores e podem constituir uma mais-valia no auxilio à gestão do paciente com EAM.

Environmental Decision Support: a Distributed Artificial Intelligence Approach

Decision making in any environmental domain is a complex and demanding activity, justifying the development of dedicated decision support systems. Every decision is confronted with a large variety and amount of constraints to satisfy as well as contradictory interests that must be sensibly accommodated. The first stage of a project evaluation is its submission to the relevant group of public (and private) agencies. The individual role of each agency is to verify, within its domain of competence, the fulfilment of the set of applicable regulations. The scope of the involved agencies is wide and ranges from evaluation abilities on the technical or economical domains to evaluation competences on the environmental or social areas. The second project evaluation stage involves the gathering of the recommendations of the individual agencies and their justified merge to produce the final conclusion. The incorporation and accommodation of the consulted agencies opinions is of extreme importance: opinions may not only differ, but can be interdependent, complementary, irreconcilable or, simply, independent. The definition of adequate methodologies to sensibly merge, whenever possible, the existing perspectives while preserving the overall legality of the system, will lead to the making of sound justified decisions. The proposed Environmental Decision Support System models the project evaluation activity and aims to assist developers in the selection of adequate locations for their projects, guaranteeing their compliance with the applicable regulations.

Six thinking hats: A novel metalearner for intelligent decision support in electricity markets

The energy sector has suffered a significant restructuring that has increased the complexity in electricity market players' interactions. The complexity that these changes brought requires the creation of decision support tools to facilitate the study and understanding of these markets. The Multiagent Simulator of Competitive Electricity Markets (MASCEM) arose in this context, providing a simulation framework for deregulated electricity markets. The Adaptive Learning strategic Bidding System (ALBidS) is a multiagent system created to provide decision support to market negotiating players. Fully integrated with MASCEM, ALBidS considers several different strategic methodologies based on highly distinct approaches. Six Thinking Hats (STH) is a powerful technique used to look at decisions from different perspectives, forcing the thinker to move outside its usual way of thinking. This paper aims to complement the ALBidS strategies by combining them and taking advantage of their different perspectives through the use of the STH group decision technique. The combination of ALBidS' strategies is performed through the application of a genetic algorithm, resulting in an evolutionary learning approach.

Enhancing Agent Mediated Electronic Markets with Ontology Matching Services and Social Network Support

Os Mercados Eletrónicos atingiram uma complexidade e nível de sofisticação tão elevados, que tornaram inadequados os modelos de software convencionais. Estes mercados são caracterizados por serem abertos, dinâmicos e competitivos, e constituídos por várias entidades independentes e heterogéneas. Tais entidades desempenham os seus papéis de forma autónoma, seguindo os seus objetivos, reagindo às ocorrências do ambiente em que se inserem e interagindo umas com as outras. Esta realidade levou a que existisse por parte da comunidade científica um especial interesse no estudo da negociação automática executada por agentes de software [Zhang et al., 2011]. No entanto, a diversidade dos atores envolvidos pode levar à existência de diferentes conceptualizações das suas necessidades e capacidades dando origem a incompatibilidades semânticas, que podem prejudicar a negociação e impedir a ocorrência de transações que satisfaçam as partes envolvidas. Os novos mercados devem, assim, possuir mecanismos que lhes permitam exibir novas capacidades, nomeadamente a capacidade de auxiliar na comunicação entre os diferentes agentes. Pelo que, é defendido neste trabalho que os mercados devem oferecer serviços de ontologias que permitam facilitar a interoperabilidade entre os agentes. No entanto, os humanos tendem a ser relutantes em aceitar a conceptualização de outros, a não ser que sejam convencidos de que poderão conseguir um bom negócio. Neste contexto, a aplicação e exploração de relações capturadas em redes sociais pode resultar no estabelecimento de relações de confiança entre vendedores e consumidores, e ao mesmo tempo, conduzir a um aumento da eficiência da negociação e consequentemente na satisfação das partes envolvidas. O sistema AEMOS é uma plataforma de comércio eletrónico baseada em agentes que inclui serviços de ontologias, mais especificamente, serviços de alinhamento de ontologias, incluindo a recomendação de possíveis alinhamentos entre as ontologias dos parceiros de negociação. Este sistema inclui também uma componente baseada numa rede social, que é construída aplicando técnicas de análise de redes socias sobre informação recolhida pelo mercado, e que permite melhorar a recomendação de alinhamentos e auxiliar os agentes na sua escolha. Neste trabalho são apresentados o desenvolvimento e implementação do sistema AEMOS, mais concretamente: • É proposto um novo modelo para comércio eletrónico baseado em agentes que disponibiliza serviços de ontologias; • Adicionalmente propõem-se o uso de redes sociais emergentes para captar e explorar informação sobre relações entre os diferentes parceiros de negócio; • É definida e implementada uma componente de serviços de ontologias que é capaz de: • o Sugerir alinhamentos entre ontologias para pares de agentes; • o Traduzir mensagens escritas de acordo com uma ontologia em mensagens escritas de acordo com outra, utilizando alinhamentos previamente aprovados; • o Melhorar os seus próprios serviços recorrendo às funcionalidades disponibilizadas pela componente de redes sociais; • É definida e implementada uma componente de redes sociais que: • o É capaz de construir e gerir um grafo de relações de proximidade entre agentes, e de relações de adequação de alinhamentos a agentes, tendo em conta os perfis, comportamento e interação dos agentes, bem como a cobertura e utilização dos alinhamentos; • o Explora e adapta técnicas e algoritmos de análise de redes sociais às várias fases dos processos do mercado eletrónico. A implementação e experimentação do modelo proposto demonstra como a colaboração entre os diferentes agentes pode ser vantajosa na melhoria do desempenho do sistema e como a inclusão e combinação de serviços de ontologias e redes sociais se reflete na eficiência da negociação de transações e na dinâmica do mercado como um todo.

Risk-based decision support system for life cycle management of industrials plants

Dissertação para obtenção do Grau de Doutor em Engenharia Electrotécnica e de Computadores

Interactive spatial decision support for sustainable agroforestry management: a case study in East Kalimantan, Indonesia

Forest managers, stakeholders and investors want to be able to evaluate economic, environmental and social benefits in order to improve the outcomes of their decisions and enhance sustainable forest management. This research developed a spatial decision support system that provides: (1) an approach to identify the most beneficial locations for agroforestry projects based on the biophysical properties and evaluate its economic, social and environmental impact; (2) a tool to inform prospective investors and stakeholders of the potential and opportunities for integrated agroforestry management; (3) a simulation environment that enables evaluation via a dashboard with the opportunity to perform interactive sensitivity analysis for key parameters of the project; (4) a 3D interactive geographic visualization of the economic, environmental and social outcomes, which facilitate understanding and eases planning. Although the tool and methodology presented are generic, a case study was performed in East Kalimantan, Indonesia. For the whole study area, it was simulated the most suitable location for three different plantation schemes: monoculture of timber, a specific recipe (cassava, banana and sugar palm) and different recipes per geographic unit. The results indicate that a mixed cropping plantation scheme, with different recipes applied to the most suitable location returns higher economic, environmental and social benefits.

The use of analytical hierarchy process in spatial decision support system for land use management

Geographic information systems give us the possibility to analyze, produce, and edit geographic information. Furthermore, these systems fall short on the analysis and support of complex spatial problems. Therefore, when a spatial problem, like land use management, requires a multi-criteria perspective, multi-criteria decision analysis is placed into spatial decision support systems. The analytic hierarchy process is one of many multi-criteria decision analysis methods that can be used to support these complex problems. Using its capabilities we try to develop a spatial decision support system, to help land use management. Land use management can undertake a broad spectrum of spatial decision problems. The developed decision support system had to accept as input, various formats and types of data, raster or vector format, and the vector could be polygon line or point type. The support system was designed to perform its analysis for the Zambezi river Valley in Mozambique, the study area. The possible solutions for the emerging problems had to cover the entire region. This required the system to process large sets of data, and constantly adjust to new problems’ needs. The developed decision support system, is able to process thousands of alternatives using the analytical hierarchy process, and produce an output suitability map for the problems faced.

Methodology for real-time adaptation of tunnels support using the observational method

The observational method in tunnel engineering allows the evaluation in real time of the actual conditions of the ground and to take measures if its behavior deviates considerably from predictions. However, it lacks a consistent and structured methodology to use the monitoring data to adapt the support system in real time. The definition of limit criteria above which adaptation is required are not defined and complex inverse analysis procedures (Rechea et al. 2008, Levasseur et al. 2010, Zentar et al. 2001, Lecampion et al. 2002, Finno and Calvello 2005, Goh 1999, Cui and Pan 2012, Deng et al. 2010, Mathew and Lehane 2013, Sharifzadeh et al. 2012, 2013) may be needed to consistently analyze the problem. In this paper a methodology for the real time adaptation of the support systems during tunneling is presented. In a first step limit criteria for displacements and stresses are proposed. The methodology uses graphics that are constructed during the project stage based on parametric calculations to assist in the process and when these graphics are not available, since it is not possible to predict every possible scenario, inverse analysis calculations are carried out. The methodology is applied to the “Bois de Peu” tunnel which is composed by two tubes with over 500 m long. High uncertainty levels existed concerning the heterogeneity of the soil and consequently in the geomechanical design parameters. The methodology was applied in four sections and the results focus on two of them. It is shown that the methodology has potential to be applied in real cases contributing for a consistent approach of a real time adaptation of the support system and highlight the importance of the existence of good quality and specific monitoring data to improve the inverse analysis procedure.

Artificial neural networks in diagnosis of liver diseases

Liver diseases have severe patients’ consequences, being one of the main causes of premature death. These facts reveal the centrality of one`s daily habits, and how important it is the early diagnosis of these kind of illnesses, not only to the patients themselves, but also to the society in general. Therefore, this work will focus on the development of a diagnosis support system to these kind of maladies, built under a formal framework based on Logic Programming, in terms of its knowledge representation and reasoning procedures, complemented with an approach to computing grounded on Artificial Neural Networks.

Information systems for water resources management improvement in developing countries

Water resources management, as also water service provision projects in developing countries have difficulties to take adequate decisions due to scarce reliable information, and a lack of proper information managing. Some appropriate tools need to be developed in order to improve decision making to improve water management and access of the poorest, through the design of Decision Support Systems (DSS). On the one side, a DSS for developing co-operation projects on water access improvement has been developed. Such a tool has specific context constrains (structure of the system, software requirements) and needs (Logical Framework Approach monitoring, organizational-learning, accountability and evaluation) that shall be considered for its design. Key aspects for its successful implementation have appeared to be a participatory design of the system and support of the managerial positions at the inception phase. A case study in Tanzania was conducted, together with the Spanish NGO ONGAWA – Ingeniería para el Desarrollo. On the other side, DSS are required also to improve decision making on water management resources in order to achieve a sustainable development that not only improves the living conditions of the population in developing countries, but that also does not hinder opportunities of the poorest on those context. A DSS made to fulfil these requirements shall be using information from water resources modelling, as also on the environment and the social context. Through the research, a case study has been conducted in the Central Rift Valley of Ethiopia, an endhorreic basin 160 km south of Addis Ababa. There, water has been modelled using ArcSWAT, a physically based model which can assess the impact of land management practices on large complex watersheds with varying soils, land use and management conditions over long periods of time. Moreover, governance on water and environment as also the socioeconomic context have been studied.

Cardiopulmonary support and extracorporeal membrane oxygenation for cardiac assist.

BACKGROUND: Use of cardiopulmonary bypass for emergency resuscitation is not new. In fact, John Gibbon proposed this concept for the treatment of severe pulmonary embolism in 1937. Significant progress has been made since, and two main concepts for cardiac assist based on cardiopulmonary bypass have emerged: cardiopulmonary support (CPS) and extracorporeal membrane oxygenation (ECMO). The objective of this review is to summarize the state of the art in these two technologies. METHODS: Configuration of CPS is now fairly standard. A mobile cart with relatively large wheels allowing for easy transportation carries a centrifugal pump, a back-up battery with a charger, an oxygen cylinder, and a small heating system. Percutaneous cannulation, pump-driven venous return, rapid availability, and transportability are the main characteristics of a CPS system. Cardiocirculatory arrest is a major predictor of mortality despite the use of CPS. In contrast, CPS appears to be a powerful tool for patients in cardiogenic shock before cardiocirculatory arrest, requiring some type of therapeutic procedures, especially repair of anatomically correctable problems or bridging to other mechanical circulatory support systems such as ventricular assist devices. CPS is in general not suitable for long-term applications because of the small-bore cannulas, resulting in significant pressure gradients and eventually hemolysis. RESULTS: In contrast, ECMO can be designed for longer-term circulatory support. This requires large-bore cannulas and specifically designed oxygenators. The latter are either plasma leakage resistent (true membranes) or relatively thrombo-resistant (heparin coated). Both technologies require oxygenator changeovers although the main reason for this is different (clotting for the former, plasma leakage for the latter). Likewise, the tubing within a roller pump has to be displaced and centrifugal pump heads have to be replaced over time. ECMO is certainly the first choice for a circulatory support system in the neonatal and pediatric age groups, where the other assist systems are too bulky. ECMO is also indicated for patients improving on CPS. Septic conditions are, in general, considered as contraindications for ECMO. CONCLUSIONS: Ease of availability and moderate cost of cardiopulmonary bypass-based cardiac support technologies have to be balanced against the significant immobilization of human resources, which is required to make them successful.

A Clinical Decision Support using a Terminology Server to improve Patient Safety.

Clinical Decision Support Systems (CDSS) are software applications that support clinicians in making healthcare decisions providing relevant information for individual patients about their specific conditions. The lack of integration between CDSS and Electronic Health Record (EHR) has been identified as a significant barrier to CDSS development and adoption. Andalusia Healthcare Public System (AHPS) provides an interoperable health information infrastructure based on a Service Oriented Architecture (SOA) that eases CDSS implementation. This paper details the deployment of a CDSS jointly with the deployment of a Terminology Server (TS) within the AHPS infrastructure. It also explains a case study about the application of decision support to thromboembolism patients and its potential impact on improving patient safety. We will apply the inSPECt tool proposal to evaluate the appropriateness of alerts in this scenario.