Medical Collaborative Expert (Demo)


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Medical Collaborative Expert (Demo)

  1. 1. Demo (2010):Medical Collaborative Expert™ working name Arbitrated Health Decisions for consumers and professionals Gil Ronen © 2010 Founder/Demo Developer
  2. 2. SynopsisOur goalsMedical Collaborative Expert was a startup founded in April 2009 by Gil Ronen and Miki Kolko. Our goals were to (1)promote participatory and shared decision-making between providers and patients by providing concise analysis ofmedical information, (2) alleviate expertise bottlenecks by bridging the divide between lay users, prosumers and medicalprofessionals, (3) provide rigorous medical reputation & trust mechanisms that help discern quality and locate expertise.The startup was called variously MyPulse and SecondOpinion. For more background see main MCE slide deck (this isthe demo slide deck).What we were building?A service providing personalized step-by-step instructions relating to medical and preventive-health decisions toconsumers, patients and medical professionals; what to do next with regards to treatments, self-tests and labprocedures, monitoring and follow-up and how to go about them. The service utilizes a new collaboration platform thataddresses quality issues by incorporating proven social arbitration mechanisms and proprietary reputation and trustalgorithms and processes. As a by-product of the service a comprehensive evaluation network is created for contentcreators providing help in locating expertise in specific topics and opportunities for professional recognition.Progressively, the service would have supported multiple delivery methods and cater to varying levels of medicalknowledge with a focus on exploiting the continuum of knowledge from lay users, to prosumers, and to various degreesof medical specialization.Where is it now?Between December 2009 and May 2010 Gil Ronen designed and developed a demo system using Python, Django andMySQL. The startup was terminated in August 2010 having failed to secure funding alongside well-funded competition. Gil Ronen © 2010
  3. 3. Vision: Social Arbitration for Consumers and Professionals Content Arbitrated Knowledge Why knowledge and not content? How do we create it? Current analysis process: search the web , Mass collaboration, a proven technique, look for similar conditions, analyze articles , utilized to generate Q&A sessions on generalize from anecdotal cases on blogs, medical topics. Proprietary accreditation filter biased content, find inconclusive and and reputation algorithms and other social contradictory conclusions, get confused, structures arbitrate between conflicting bring stack of printouts to physician office elements for state-of-the-art conclusions. visit, request various tests and medications, Knowledge authors share ad revenue experience side-effects, start over based on their effectiveness in high-quality content production Status Quo Solutions Our Solution Domain-specific searches identify more Envisions personalized step-by-step materials, portals provide more instructions relating to medical and information, tools targeting professionals preventive-health decisions for consumers, identify articles and ongoing clinical trials patients and medical professionals. Our and provide less than cutting-edge solution helps create quality knowledge diagnosis, and identify where expertise layGil Ronen © 2010
  4. 4. DemoFor further background see the Medical Collaborative Expert slides (not the demo).Demo written in Python with Django and MySQL from December 2009 to May 2010. Gil Ronen © 2010
  5. 5. Part I: Use Guide to Get Medical RecommendationsGil Ronen © 2010
  6. 6. Search for a Guide and Select to Start Visitors search for medical guides to particular topics. A selected guide can be invoked to provide individually tailored recommendations.Gil Ronen © 2010
  7. 7. Answer Guide Questions and View Recommendations Users answer guide questions to get tailored recommendations. Each additional response changes the recommendations shown to the users.. Guide questions Possible responses Recommendations (actions). A new guide may be invoked if the user requires assistance in answering a particular question.Gil Ronen © 2010
  8. 8. Part II: Author Guides CollaborativelyGil Ronen © 2010
  9. 9. Log In as Registered User or Guest Entry point for Collaborative Medical Expert (aka, ) Login includes locality for guest users.Gil Ronen © 2010
  10. 10. Dashboard for User ‘gilnyc’ gilnyc logged in and has a reputation score of 97.4. The guides in the repository can be applied en masse to a user’s online medical records providing recommendations that change over time as guides are updated by the community or new test results are entered into the Find Guide is the main user’s medical record. screen for finding and applying medical guides.Gil Ronen © 2010
  11. 11. Find Guide to Edit Search for topics related to ‘nursing problem’. A single medical expert (guide) is found when using ‘nursing problem’ as the search keyword. The guide can now be either started or edited.Gil Ronen © 2010
  12. 12. Edit ‘Nursing Problems’ Guide Guides are built collaboratively by many users over time. A guide consists of questions that specialize the recommendations based on the user’s responses.Gil Ronen © 2010
  13. 13. View ‘Nursing Problems’ Guide Recommendations Recommendations (Actions) correspond to a pattern of responses within the guide – when a user starts a guide and responds to questions, the recommendations that closest match the pattern of responses rise to the top of the displayed recommendations.Gil Ronen © 2010
  14. 14. Edit Recommendation (Action) Triggers for ‘Nursing Problems’ Guide A recommendation is associated with a set of responses to the guide’s questions. A question can be skipped if its response is not relevant to the recommendation.Gil Ronen © 2010
  15. 15. Edit Supports for ‘See an Osteopath’ Recommendation A recommendation is supported by links to support materials such as articles or documented anecdotal evidence.Gil Ronen © 2010
  16. 16. Phonetic Search Logout user ‘gilnyc’ and login as ‘DrBob’. Notice lower reputation score of 26.5. Phonetic search on ‘slip apiya’ results in two guides being presented.Gil Ronen © 2010
  17. 17. Edit ‘Obstructive Sleep Apnea’ Guide User DrBob with low reputation score wishes to edit the question ‘Are you sleepy during the day’?Gil Ronen © 2010
  18. 18. Edit Question ‘Are you sleepy during the day?’ The question belongs to the ‘Obstructive Sleep Apnea’ guide and consists of 3 possible responses. The question also has three recommendations (actions), two of which suggest performing additional tests.Gil Ronen © 2010
  19. 19. Adding New Possible Answer Adding a new possible answer (‘In the afternoon’) to the question.Gil Ronen © 2010
  20. 20. Position of New Answer Answer is added as last response option.Gil Ronen © 2010
  21. 21. Part III: Collaborative ProcessGil Ronen © 2010
  22. 22. Proposed Deletion of Response Option Dr Bob tries to delete an answer option for one of the guide questions but because of a low user reputation score the proposal requires additional support from other users. In essence, DrBob needs to pool reputation with other users to affect the proposed change and make it available to others. Dr Bob can vote on the proposal and provide support and the proposal will be pending other votes.Gil Ronen © 2010
  23. 23. Crux of Collaboration: Providing Support for Content Proposal Based on Argumentation Theory, supporting an argument, or objecting to an argument, fall under one of several pre-defined categories. The user votes not only by applying their reputation score to their support or objection but are required to do so within a selected category. Users are encouraged, but not required, to provide additional materials for the benefit of other prospective voters on the proposal at hand. Dr Bob selects to support his proposal by choosing the ‘expert’ support category: DrBob wrote ‘the book’ on Sleep Apnea and claims to be an expert in the field. Of course, citations and links are needed to support this claim.Gil Ronen © 2010
  24. 24. Recording Support for Proposal Dr Bob’s vote is counted and the current support and threshold for acceptance of the proposal are displayed:Gil Ronen © 2010
  25. 25. An Arbitration Action is Required on the ‘Obstructive Sleep Apnea’ Guide A different user logs in. Despite the name, user ‘baba’ has a high reputation score and therefore will have more impact on proposals than DrBob. The user selects to work on the guide ‘Obstructive Sleep Apnea’ and sees that there is a question that has a proposal pending. In the parlance of the Collaborative Medical Expert, it requires Social Arbitration. The user may have been subscribed to this guide and therefore received a notification that arbitration is needed.Gil Ronen © 2010
  26. 26. Social Arbitration of Proposal User votes in support of proposal using the Standard Procedure support category. Clicking on ‘what?’ for a category will bring up an explanation, in this case for the Research support category.Gil Ronen © 2010
  27. 27. Proposal Accepted Vote is sufficient to cross the Acceptance Threshold and so the proposal to delete a response option from the question is accepted. The same process is followed for other changes to a guide. Depending on the Acceptance Threshold of the proposal, the reputation of the content and the reputation of the users involved, the process may be immediate or more involved: simple changes to low reputation content by high reputation users would go into affect without additional arbitration. For other content it may be prudent to have a more involved process of deliberation between knowledgeable users through the Argumentation mechanisms provided.Gil Ronen © 2010
  28. 28. Part IV: Publish Guide ChangesGil Ronen © 2010
  29. 29. Publish Guide on Obstructive Sleep Apnea Click Publish to make guide changes visible to guide users.Gil Ronen © 2010
  30. 30. Part V: User Reputation and Content ReputationGil Ronen © 2010
  31. 31. User Reputation Enhancement Logging in again as user ‘DrBob’ we see that the reputation score was enhanced by acceptance of the proposal authored by this user. The increase is small reflecting the Reputation mechanism highlights: value of the change. Note that the user reputation score is not simply 1. A user whose proposal is accepted sees an cumulative but is in relation to the increase in reputation. scores of other users. 2. A guide that is created by high reputation authors will itself have a high reputation that manifests as higher Acceptance Threshold values for future proposed changes. 3. Positive ratings for a guide will reflect on the reputation of its authors in correlation to their contribution.Gil Ronen © 2010
  32. 32. Appendix: Collaborative Medical Expert Server Log Snapshot