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1Semantic Web & Web 3.0 empowering realworld outcomes in biomedical research andclinical practicesAmit ShethKno.e.sis – Oh...
Integration
Semantics
Role of Semantic Web in HCLS• Improve the machine understandability andprocessing of all types of data by• Modeling and Ba...
Identifiers: URI Character set: UNICODESyntax: XMLData interchange: RDFQuerying:SPARQLTaxonomies: RDFSOntologies:OWLRules:...
HCLS Apps @ Kno.e.sis• Semantic Search andBrowsing(Doozer++,SCOONER, iExplore)• Semantics and Servicesenabled Problem Solv...
InsightsBetterUnderstandingIntuitiveBrowsingHypothesisGenerationPersonalizationKnowledgeExplorationDoozer++iExploreSCOONER...
Knowledge Acquisition – Doozer++• Building ontology is costly• Large volume of knowledge available in semi-structured/unst...
Knowledge Acquisition – Doozer++Circle of Knowledgehttp://knoesis.org/node/71
Knowledge Acquisition – Doozer++
Knowledge Acquisition – Doozer++
j.1:category_sciencej.1:category_neurosciencej.1:category_cognitive_sciencej.1:category_psychologyj.1:category_behaviorj.1...
Doozer++ DemoKnowledge Acquisition from Community-Generated ContentContinuous Semantics to Analyze Real-Time Data , IEEE I...
• Identify Relationships• Textual pattern-based extraction for knownrelationships• Facts available in background knowledge...
• Evaluating acquired knowledge• Explicit• User can vote for facts• Facts presented based on user interests• Implicit• Use...
Base Hierarchy fromWikipediaSenseLab NeuroscienceOntologiesMeta KnowledgebasePubMed AbstractsFocused patternbased extracti...
Use Case for HPCO• Number of Entities – 2 million• Number of non-trivial facts – 3 million• NLP Based*: calcium-binding pr...
Knowledge-based Browsing - SCOONER• Knowledge-based browsing: relations window,inverse relations, creating trails• Persist...
SCOONER DemoSCOONER DetailsAn Up-to-date Knowledge-Based Literature Search and Exploration Framework for FocusedBioscience...
Kino• An integrated suite of tools that enablesscientists to annotate– unstructured resources– semi-structured resources• ...
Kino Architecture
Example: Annotating Literature
Annotation the XML file withNCBO OntologyrelrelOntologyconcept
Kino Search•Search the annotated document with the concept of interest•Return all annotated document with selected concept
Kino DemoKino: A Generic Document Management System for Biologists Using SA-REST and Faceted Search. ICSC 2011
iExploreInteractive Browsing and ExploringBiomedical Knowledge
Architecture
Generate Novel Hypothesis
iExplore videoiExplore Demo
Turning toApplications with End Users
Active Semantic Electronic MedicalRecord - ASEMR• New Drugs• Adds interaction with current drugs• Changes possible procedu...
• A Document• With semantic annotations• entities linked to ontology• terms linked to specialized lexicon• With actionable...
• Type of ASD• Three Ontologies• PracticeInformation about practice such aspatient/physician data• DrugInformation about d...
encounterancillaryeventinsurance_carrierinsurancefacilityinsurance_planpatientpersonpractitionerinsurance_policyowl:thinga...
owl:thingprescription_drug_brand_namebrandname_undeclaredbrandname_compositeprescription_drugmonograph_ix_classcpnum_group...
ASEMR
0100200300400500600Jan04Mar04May04Jul04Sept04Nov04Jan05Mar05May05Jul05Month/YearChartsSame DayBack LogBefore ASEMR
0100200300400500600700Sept05Nov 05 Jan 06 Mar 06Month/YearChartsSame DayBack LogAfter ASEMR
• Error Prevention• Patient care• Insurance• Decision Support• Patient satisfaction• Reimbursement• Efficiency/Time• Real-...
ASEMR DemoActive Semantic Electronic Medical Record, ISWC 2006
Semantics and Services enabledProblem Solving Environment forT.cruzi - SPSE• Majority of experimental data reside in labs•...
SPSE• Data Sources• Internal Lab Data• External Database• OntologicalInfrastructure• Parasite Lifecycle• ParasiteExperimen...
• Integrated internal data with external databases, such asKEGG, GO, and some datasets on TriTrypDB• Developed semantic pr...
Complex queries can also include:- on-the-fly Web services execution to retrieve additional data- inference rules to make ...
• So many ontologies• Rich in number of concepts• Mostly concentrated on taxonomicalrelationships• Applications require do...
DataInformationKnowledgeKnowledge Enrichment from Data
IntellegOBackgroundknowledgeModified backgroundknowledgeEMRKnowledge Enrichment from DataData Driven Knowledge Acquisition...
Knowledge Enrichment from Dataatrial Fibrillationhypertensiondiabeteschest painweight gaindiscomfort in chestrash skincoug...
DomainsCardiologyOrthopedicsOncologyNeurologyEtc…No of concepts 1008161Problems(diseases, symptoms) 125778Procedures 26236...
• 80% unstructured healthcare data• Pose challenges in• Searching• Understanding• Mining• Knowledge discovery• Decision su...
Coding Complexity ICD-9 ICD-10Diagnostic Codes 14,000 69,000Procedure Codes 3,800 72,000ICD-9(Current)ICD-10 Conversion(1s...
• Traditional methods doesn’t work• Understanding the context is crucialNeed to Do BetterHealthcare Challenge
Search MiningDecision SupportKnowledge Discovery Evidence-based MedicineNLP+SemanticsHealthcare Challenge – The Solution
ezHealthcTAKESezNLPezKB<problem value="Asthma" cui="C0004096"/><med value="Losartan" code="52175:RXNORM" /><med value="Spi...
ezHealth - Benefits• Advance search• All hypertension patients with ejectionfraction <40• All MI patients who are taking e...
Error DetectionEMR:1. “Sepsis due to urinary tract infection….”2. “Her prognosis is poor both short term and long term, ho...
EMR: ”The patient is to receive 2 fluid boluses."SNM:32457005_body_fluidA syntax based NLP extractor(such as Medlee) can e...
The balance of evidence would suggestthat his episode of atrial fibrillation seemsto be an isolated eventHe has had no doc...
She denies any chest pain but is not reallyfunction due to leg stiffness, swelling anshortness of breathRegarding the shor...
PREscription Drug abuse OnlineSurveillance and Epidemiology -PREDOSE• Non-medical use of Prescription Drugs• Fastest Growi...
Specific AimsDescribe drug user’s knowledge, attitudes,and behaviors related to illicit use ofPrescription Drugs (Content ...
Overall Approach1. Automate Data Collection• Social Media - Online Web forums2. Create Structured Domain Vocabulary• Drug ...
WebCrawlerInformal Text DatabaseWeb Forums2458Data CleaningStage 1. Data Collection3Stage 2. Automatic CodingStage 3. Data...
Research HighlightsDrug Abuse Ontology• First ontology on prescription drug abuseOntology-based Entity Identification• Gol...
Research HighlightsTemplate-based (Knowledge-Aware) Search• Complex Information NeedsSolution1. Ontology-based Search2. Ru...
Entity+ve SentimentOpiated EffectExtra-medical Use of LoperamideLoperamide-Withdrawal Discovery
kHealth71Health information is now available from multiple sources• medical records• background knowledge• social networks...
72Foursquare is an online application whichintegrates a persons physical location andsocial network.Community of enthusias...
73Sensors, actuators, and mobile computing are playing anincreasingly important role in providing data for early phases of...
74kHealth
75Personal Health DashboardkHealth
76Personal Health Dashboard1  2  3Continuous Monitoring Personal Assessment Medical ServiceAuxiliary Information – backg...
77?kHealth
kHealth – Key Ingredients78Background KnowledgeSocial Network InputPersonal ObservationsPersonal Medical History
79AbstractionsObservationskHealth
80kHealth - Technologyobservesinheres inperceivessendsfocussendsobservationObserver QualityEntityPerceiver
82kHealth - TechnologyBackgroundKnowledge asBi-partite Graph
83kHealth - TechnologyExplanation: is the act of choosing the objects or events that bestaccount for a set of observations...
84kHealth - TechnologyExplanatory Feature: a feature that explains the set ofobserved propertiesExplanatoryFeature ≡ ∃ssn:...
85kHealth - TechnologyDiscriminationExpected Property: would be explained by every explanatoryfeatureExpectedProperty ≡ ∃s...
86kHealth - TechnologyDiscriminationNot Applicable Property: would not be explained by anyexplanatory featureNotApplicable...
87kHealth - TechnologyDiscriminationDiscriminating Property: is neither expected nor not-applicableDiscriminatingProperty ...
90kHealth DemoAn Ontological Approach to Focusing Attention and Enhancing Machine Perception on the Web, Applied Ontology ...
91kHealth
92kHealth - Asthma• Can we detect asthma/allergy early?– Using data from on-body sensors, and environmental sensors– Using...
• GO (well controlled)– peak flow 80-100%*– Good breathing and sleep: Acceleration reading pattern– No cough: microphone– ...
94Physical Socialhttp://ngs.ics.uci.edu/blog/?p=1478CyberData CollectionAnalysisActionTake Medication before going to work...
95PersonalLevel EventsPopulation LevelEvents(Personal Level Events)(Personalized Events) (Population Level Events)Populati...
96Community SpacesPersonal SpacesPersonalWheeze – YesDo you have tightness of chest? –YesObservationsPhysical-Cyber-Social...
• Collaborators: AHC (Dr. Agrawal), CITAR-WSU, ezDI(ezdi.us), NLM (Dr. Bodenrider), CTEGD-UGA (Dr.Mnning/Prof. Tarleton), ...
Thank YouVisit Us @www.knoesis.orgwith additional background at http://knoesis.org/amit/hcls
Ohio Center of Excellence in Knowledge-enabled Computing -An Ohio Center of Excellence in BioHealth InnovationWright State...
Amit Sheth’sPHD studentsAshutosh JadhavHemantPurohitVinhNguyenLu ChenPavanKapanipathiPramodAnantharamSujanPereraAlan Smith...
Semantic Web & Web 3.0 empowering real world outcomes in biomedical research and clinical practices
Semantic Web & Web 3.0 empowering real world outcomes in biomedical research and clinical practices
Semantic Web & Web 3.0 empowering real world outcomes in biomedical research and clinical practices
Semantic Web & Web 3.0 empowering real world outcomes in biomedical research and clinical practices
Semantic Web & Web 3.0 empowering real world outcomes in biomedical research and clinical practices
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Semantic Web & Web 3.0 empowering real world outcomes in biomedical research and clinical practices

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Talk presented in Spain (WiMS 2013/UAM-Madrid, UMA-Malaga), June 2013.

Replaces earlier version at: http://www.slideshare.net/apsheth/semantic-technology-empowering-real-world-outcomes-in-biomedical-research-and-clinical-practices

Biomedical and translational research as well as clinical practice are increasingly data driven. Activities routinely involve large number of devices, data and people, resulting in the challenges associated with volume, velocity (change), variety (heterogeneity) and veracity (provenance, quality). Equally important is to realize the challenge of serving the needs of broader ecosystems of people and organizations, extending traditional stakeholders like drug makers, clinicians and policy makers, to increasingly technology savvy and information empowered patients. We believe that semantics is becoming centerpiece of informatics solutions that convert data into meaningful, contextually relevant information and insights that lead to optimal decisions for translational research and 360 degree health, fitness and well-being.
In this talk, I will provide a series of snapshots of efforts in which semantic approach and technology is the key enabler. I will emphasize real-world and in-use projects, technologies and systems, involving significant collaborations between my team and biomedical researchers or practicing clinicians. Examples include:
• Active Semantic Electronic Medical Record
• Semantics and Services enabled Problem Solving Environment for T.cruzi (SPSE)
• Data Mining of Cardiology data
• Semantic Search, Browsing and Literature Based Discovery
• PREscription Drug abuse Online Surveillance and Epidemiology (PREDOSE)
• kHealth: development of a knowledge-enhanced sensing and mobile computing applications (using low cost sensors and smartphone), along with ability to convert low level observations into clinically relevant abstractions

Further details are at http://knoesis.org/amit/hcls

Published in: Education, Health & Medicine
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Semantic Web & Web 3.0 empowering real world outcomes in biomedical research and clinical practices

  1. 1. 1Semantic Web & Web 3.0 empowering realworld outcomes in biomedical research andclinical practicesAmit ShethKno.e.sis – Ohio Center of Excellence in Knowledge-enabled ComputingWright State University, Dayton, Ohiohttp://knoesis.orghttp://knoesis.org/amit/hclsSpecial thanks: Sujan Perera; Ack: Kno.e.sis HCLS team and collaboratorsTalk presented in Spain (WiMS 2013/UAM-Madrid, UMA-Malaga), June 2013
  2. 2. Integration
  3. 3. Semantics
  4. 4. Role of Semantic Web in HCLS• Improve the machine understandability andprocessing of all types of data by• Modeling and Background Knowledge• Annotation• Complex Querying/Analysis, Reasoning• Improve Insight from Biomedical Data• Improve Clinical Decision Making• Vastness/Volume• Velocity• Variety/Heterogeneity• Vagueness, Uncertainty, Inconsistency, DeceitObjectiveChallengesApproach
  5. 5. Identifiers: URI Character set: UNICODESyntax: XMLData interchange: RDFQuerying:SPARQLTaxonomies: RDFSOntologies:OWLRules:RIF/SWRLUnifying logicProofTrustCryptographyUser interface and applicationsQueryingData/KnowledgeRepresentationKnowledgeRepresentationLots of need for NLP, ML, IR, and other technologies –SW significantly empowers these and closes some critical gaps
  6. 6. HCLS Apps @ Kno.e.sis• Semantic Search andBrowsing(Doozer++,SCOONER, iExplore)• Semantics and Servicesenabled Problem SolvingEnvironment forT.cruzi(SPSE)• Active Semantic ElectronicMedical Record(ASEMR)• Mining and Analysis ofEMR(ezFIND, ezMeasure,ezCAC)• kHealth (ADHF, Asthma, …)• PREscription Drug abuseOnline Surveillance andEpidemiology(PREDOSE)BiomedicalHealthcareEpidemiology
  7. 7. InsightsBetterUnderstandingIntuitiveBrowsingHypothesisGenerationPersonalizationKnowledgeExplorationDoozer++iExploreSCOONERKinoKno.e.sis Bioinformatics toolkithttp://knoesis.org/opensourcehttp://knoesis.org/showcase
  8. 8. Knowledge Acquisition – Doozer++• Building ontology is costly• Large volume of knowledge available in semi-structured/unstructured format• No assurance for the credibility of suchknowledge
  9. 9. Knowledge Acquisition – Doozer++Circle of Knowledgehttp://knoesis.org/node/71
  10. 10. Knowledge Acquisition – Doozer++
  11. 11. Knowledge Acquisition – Doozer++
  12. 12. j.1:category_sciencej.1:category_neurosciencej.1:category_cognitive_sciencej.1:category_psychologyj.1:category_behaviorj.1:category_philosophy_of_mindj.1:category_brainj.1:category_psycholinguisticsj.1:category_neurologyj.1:category_neurophysiology10 classes…Knowledge Acquisition – Doozer++
  13. 13. Doozer++ DemoKnowledge Acquisition from Community-Generated ContentContinuous Semantics to Analyze Real-Time Data , IEEE Internet Computing (Volume 14)
  14. 14. • Identify Relationships• Textual pattern-based extraction for knownrelationships• Facts available in background knowledge• Find evidence for such facts• Combined evidence from many differentpatterns increases the certainty of arelationship between the entitiesBeyond Hierarchy
  15. 15. • Evaluating acquired knowledge• Explicit• User can vote for facts• Facts presented based on user interests• Implicit• User’s browsing history used as a indication ofwhich propositions are correct and interesting• Now it adds validated knowledge back to communityValidating Knowledge
  16. 16. Base Hierarchy fromWikipediaSenseLab NeuroscienceOntologiesMeta KnowledgebasePubMed AbstractsFocused patternbased extractionInitial KB creationEnrichedKnowledgebaseHPCKeywordsKno.e.sis: NLPbased triplesNLM: Rule basedBKR triplesBuilding Human Performance &Cognition Ontology (HPCO)Mergehttp://wiki.knoesis.org/index.php/Human_Performance_and_Cognition_Ontology
  17. 17. Use Case for HPCO• Number of Entities – 2 million• Number of non-trivial facts – 3 million• NLP Based*: calcium-binding protein S100Bmodulates long-term synaptic plasticity• Pattern Based**: Olfactory Bulb has physicalpart of anatomic structure Mitral cell* Joint Extraction of Compound Entities and Relationships from Biomedical Literature , Web Intel. 2008* A Framework for Schema-Driven Relationship Discovery from Unstructured Text, ISWC 2006** On Demand Creation of Focused Domain Models using Top-down and Bottom-up Information Extraction, TechnicalReport
  18. 18. Knowledge-based Browsing - SCOONER• Knowledge-based browsing: relations window,inverse relations, creating trails• Persistent Projects: Work bench, Browsinghistory, Comments, Filtering• Collaboration: Comments, Dashboard, Exportingprojects, Importing projects
  19. 19. SCOONER DemoSCOONER DetailsAn Up-to-date Knowledge-Based Literature Search and Exploration Framework for FocusedBioscience Domains , IHI 2012- 2nd ACM SIGHIT International Health Informatics Symposium
  20. 20. Kino• An integrated suite of tools that enablesscientists to annotate– unstructured resources– semi-structured resources• Annotates documents by accessing NCBOontologies, via the NCBO Web API.• Includes two main components– A browser-based annotation front-end– An annotation-aware back-end index that providesfaceted search capabilities
  21. 21. Kino Architecture
  22. 22. Example: Annotating Literature
  23. 23. Annotation the XML file withNCBO OntologyrelrelOntologyconcept
  24. 24. Kino Search•Search the annotated document with the concept of interest•Return all annotated document with selected concept
  25. 25. Kino DemoKino: A Generic Document Management System for Biologists Using SA-REST and Faceted Search. ICSC 2011
  26. 26. iExploreInteractive Browsing and ExploringBiomedical Knowledge
  27. 27. Architecture
  28. 28. Generate Novel Hypothesis
  29. 29. iExplore videoiExplore Demo
  30. 30. Turning toApplications with End Users
  31. 31. Active Semantic Electronic MedicalRecord - ASEMR• New Drugs• Adds interaction with current drugs• Changes possible procedures to treat anillness• Insurance coverage changes• Will pay for drug X, but not Y• May need certain diagnosis beforeexpensive tests• Physicians are require to keep track of everchanging landscape
  32. 32. • A Document• With semantic annotations• entities linked to ontology• terms linked to specialized lexicon• With actionable information• rules over semantic annotations• rule violation indicated with alertsAtrial fibrillation with prior stroke, currentlyon Pradaxa, doing well.Mild glucose intolerance and hyperlipidemia,being treated by primary care.ASEMR – Active Semantic Document
  33. 33. • Type of ASD• Three Ontologies• PracticeInformation about practice such aspatient/physician data• DrugInformation about drugs, interaction,formularies, etc.• ICD/CPTDescribes the relationships between CPTand ICD codesASEMR – Active Semantic Patient Record
  34. 34. encounterancillaryeventinsurance_carrierinsurancefacilityinsurance_planpatientpersonpractitionerinsurance_policyowl:thingambularory_episodeASEMR – Practice Ontology Hierarchy
  35. 35. owl:thingprescription_drug_brand_namebrandname_undeclaredbrandname_compositeprescription_drugmonograph_ix_classcpnum_groupprescription_drug_propertyindication_propertyformulary_propertynon_drug_reactantinteraction_propertypropertyformularybrandname_individualinteraction_with_prescription_druginteractionindicationgeneric_individualprescription_drug_genericgeneric_compositeinteraction_with_non_drug_reactantinteraction_with_monograph_ix_classASEMR – Drug Ontology Hierarchy
  36. 36. ASEMR
  37. 37. 0100200300400500600Jan04Mar04May04Jul04Sept04Nov04Jan05Mar05May05Jul05Month/YearChartsSame DayBack LogBefore ASEMR
  38. 38. 0100200300400500600700Sept05Nov 05 Jan 06 Mar 06Month/YearChartsSame DayBack LogAfter ASEMR
  39. 39. • Error Prevention• Patient care• Insurance• Decision Support• Patient satisfaction• Reimbursement• Efficiency/Time• Real-time chart completion• “semantic” and automated linking withbillingASEMR - Benefits
  40. 40. ASEMR DemoActive Semantic Electronic Medical Record, ISWC 2006
  41. 41. Semantics and Services enabledProblem Solving Environment forT.cruzi - SPSE• Majority of experimental data reside in labs• Integration of lab data facilitate new insights• Formulating queries against such data requireddeep technical knowledgeA Semantic Problem Solving Environment for Integrative Parasite Research:Identification of Intervention Targets for Trypanosoma cruzi, 2012
  42. 42. SPSE• Data Sources• Internal Lab Data• External Database• OntologicalInfrastructure• Parasite Lifecycle• ParasiteExperiment• Query Processing• Cuebee
  43. 43. • Integrated internal data with external databases, such asKEGG, GO, and some datasets on TriTrypDB• Developed semantic provenance framework and influencedW3C community• SPSE supports complex biological queries that help findgene knockout, drug and/or vaccination targets. Forexample:• Show me proteins that are downregulated in the epimastigotestage and exist in a single metabolic pathway.• Give me the gene knockout summaries, both for plasmidconstruction and strain creation, for all gene knockout targets thatare 2-fold upregulated in amastigotes at the transcript level andthat have orthologs in Leishmania but not in Trypanosoma brucei.SPSE
  44. 44. Complex queries can also include:- on-the-fly Web services execution to retrieve additional data- inference rules to make implicit knowledge explicitSPSE
  45. 45. • So many ontologies• Rich in number of concepts• Mostly concentrated on taxonomicalrelationships• Applications require domain relationships• A is_symptom_of B• C is_treated_with DKnowledge Enrichment from Data
  46. 46. DataInformationKnowledgeKnowledge Enrichment from Data
  47. 47. IntellegOBackgroundknowledgeModified backgroundknowledgeEMRKnowledge Enrichment from DataData Driven Knowledge Acquisition Method for Domain Knowledge Enrichment in Healthcare, BIBM2012An Ontological Approach to Focusing Attention and Enhancing Machine Perception on the Web,Applied Ontology 2011
  48. 48. Knowledge Enrichment from Dataatrial Fibrillationhypertensiondiabeteschest painweight gaindiscomfort in chestrash skincoughweight lossheadacheedemashortness of breathfatiguesyncopeweight losschest paindiscomfort in chestdizzyshortness of breathnauseavomitingheadachecoughweight gainDiseasesSymptomsSymptomsFrom EMR From KBIs edema symptom of atrial fibrillation?Is edema symptom of hypertension?Is edema symptom of diabetes?
  49. 49. DomainsCardiologyOrthopedicsOncologyNeurologyEtc…No of concepts 1008161Problems(diseases, symptoms) 125778Procedures 262360Medicines 298993Medical Devices 33124Relationships 77261is treated with (disease -> medication) 41182is relevant procedure (procedure -> disease) 3352is symptom of (symptom -> disease) 8299contraindicated drug (medication -> disease) 24428Knowledge Enrichment from Datawith the abovemethod+UMLShealthline.comdruglib.com
  50. 50. • 80% unstructured healthcare data• Pose challenges in• Searching• Understanding• Mining• Knowledge discovery• Decision support• Evidence based medicine• Federal policies promote meaningful use andpose constraints to healthcare systemHealthcare Challenge
  51. 51. Coding Complexity ICD-9 ICD-10Diagnostic Codes 14,000 69,000Procedure Codes 3,800 72,000ICD-9(Current)ICD-10 Conversion(1st Oct,2014)ClinicalDocumentation &Coding-BillingChallengesExample: 821.01: ICD-9 code for “closed” Fractured Femur, or thigh bone.Translates to 36 codes in ICD-10 with details regarding the precise nature offracture, which thigh was fractured, whether a delay in healing occurred etc.Healthcare Challenge
  52. 52. • Traditional methods doesn’t work• Understanding the context is crucialNeed to Do BetterHealthcare Challenge
  53. 53. Search MiningDecision SupportKnowledge Discovery Evidence-based MedicineNLP+SemanticsHealthcare Challenge – The Solution
  54. 54. ezHealthcTAKESezNLPezKB<problem value="Asthma" cui="C0004096"/><med value="Losartan" code="52175:RXNORM" /><med value="Spiriva" code="274535:RXNORM" /><procedure value="EKG" cui="C1623258" />ezFIND ezMeasure ezCDIezCACwww.ezdi.us
  55. 55. ezHealth - Benefits• Advance search• All hypertension patients with ejectionfraction <40• All MI patients who are taking either beta-blockers or ACE Inhibitors• Patients diagnose with Atrial Fibrillation onCoumadin or Lovanox• Support core-measure initiative
  56. 56. Error DetectionEMR:1. “Sepsis due to urinary tract infection….”2. “Her prognosis is poor both short term and long term, however, wewill do everything possible to keep her alive and battle this infection."SNM:40733004_infection SNM:68566005_infection_urinary_tractA syntax based NLP extractor(such as Medlee) can extractthis term and annotate asSNM:40733004_infectionBy utilizing IntellegO and cardiologybackground knowledge, we can moreaccurately annotate the term asSNM:68566005_infection_urinary_tract*MedLEEwith usage of IntellegOProblem Problem*MedLEE is NLP engine optimized to parse clinical documents
  57. 57. EMR: ”The patient is to receive 2 fluid boluses."SNM:32457005_body_fluidA syntax based NLP extractor(such as Medlee) can extractthis term and annotate asSNM:32457005_body_fluidMedLEEProblemFluid is part of buloses treatment, not a problemwith IntellegOBy utilizing IntellegO and cardiologybackground knowledge, we can determinethat this is not a symptom – henceannotation is incorrect.TreatmentError Detection
  58. 58. The balance of evidence would suggestthat his episode of atrial fibrillation seemsto be an isolated eventHe has had no documented atrialfibrillation since that timePatient has atrial fibrillationPatient does not have atrialfibrillationNLPNLPAtrial FibrillationSyncopeIs_symptom_ofWarfarinAtenololAspirinIs_medication_forResolve InconsistencyUsing domain relationships wevalidated that patient has atrialfibrillationSymptoms MedicationMedicationMedication
  59. 59. She denies any chest pain but is not reallyfunction due to leg stiffness, swelling anshortness of breathRegarding the shortness of breath, we willsend for a dobutamine stressechocardiogramPatient does not haveshortness of breathPatient has shortness of breathNLPNLPShortness of BreathIs_symptom_ofObesityHypertensionSleep ApneaObstructiveResolve InconsistencyUsing domain relationships wevalidated that patient hasshortness of breathDisorderDisorderDisorder
  60. 60. PREscription Drug abuse OnlineSurveillance and Epidemiology -PREDOSE• Non-medical use of Prescription Drugs• Fastest Growing Drug problem in US• Director ONDCP Gil Kerlikowske, Epidemic*• Pathway to heroin addiction• Escalating accidental overdose deaths• Current Epidemiological Data Systems• Interactive Interviews• Online Surveys• Manual Coding
  61. 61. Specific AimsDescribe drug user’s knowledge, attitudes,and behaviors related to illicit use ofPrescription Drugs (Content Analysis)Describe temporal patterns of non-medicaluse of Prescription Drugs(Trend Analysis)
  62. 62. Overall Approach1. Automate Data Collection• Social Media - Online Web forums2. Create Structured Domain Vocabulary• Drug Abuse Ontology (DAO)3. Automate Information Extraction• Entity, Relationship, Triple, Sentiment, Template4. Develop Tools for Data Analysisa) Content Analysis - Content Explorer, Template PatternExplorer, Proximity Searchb) Trend Analysis - Trend explorer, Emerging pattern explorer
  63. 63. WebCrawlerInformal Text DatabaseWeb Forums2458Data CleaningStage 1. Data Collection3Stage 2. Automatic CodingStage 3. Data Analysis and Interpretation16Qualitative and Quantitative Analysisof Drug User Knowledge, Attitudesand Behaviors+ =Semantic Web DatabaseInformation Extraction ModuleTemporal Analysis for Trend Detection10Triples/RDF DatabaseEntityIdentificationSentimentExtractionRelationshipExtractionTriple Extraction7Opioid, Cannabinoid,Side Effect, Feeling[Buprenorphine has_slang_term bupe][Suboxone subClassOf Buprenorphine][Suboxone_Injection CAUSES Nausea]Drug Abuse Ontology(Schema)9PREDOSE Web Application9
  64. 64. Research HighlightsDrug Abuse Ontology• First ontology on prescription drug abuseOntology-based Entity Identification• Gold standard dataset 601 posts• Buprenorphine – 33:1 Slang-to-drug mentions• Loperamide – 24:1 Slang-to-drug mentions:• 85% Precision, 72% Recall
  65. 65. Research HighlightsTemplate-based (Knowledge-Aware) Search• Complex Information NeedsSolution1. Ontology-based Search2. Rule-based Search – Intensity, Frequency, Dosage, Interval3. Context-Free Grammar – Queries Interpretable by PREDOSE4. Data Sources – Ontology, Lexicon, Lexico-ontology, Alphabet
  66. 66. Entity+ve SentimentOpiated EffectExtra-medical Use of LoperamideLoperamide-Withdrawal Discovery
  67. 67. kHealth71Health information is now available from multiple sources• medical records• background knowledge• social networks• personal observations• sensors• etc.
  68. 68. 72Foursquare is an online application whichintegrates a persons physical location andsocial network.Community of enthusiasts that share experiences ofself-tracking and measurement.FitBit Community allows theautomated collection andsharing of health-related data,goals, and achievementskHealth
  69. 69. 73Sensors, actuators, and mobile computing are playing anincreasingly important role in providing data for early phases ofthe health-care life-cycleThis represents a fundamental shift:• people are now empowered to monitor and manage their own health;• and doctors are given access to more data about their patientskHealth
  70. 70. 74kHealth
  71. 71. 75Personal Health DashboardkHealth
  72. 72. 76Personal Health Dashboard1  2  3Continuous Monitoring Personal Assessment Medical ServiceAuxiliary Information – background knowledge, social/community support,personal context, personal medical historykHealth
  73. 73. 77?kHealth
  74. 74. kHealth – Key Ingredients78Background KnowledgeSocial Network InputPersonal ObservationsPersonal Medical History
  75. 75. 79AbstractionsObservationskHealth
  76. 76. 80kHealth - Technologyobservesinheres inperceivessendsfocussendsobservationObserver QualityEntityPerceiver
  77. 77. 82kHealth - TechnologyBackgroundKnowledge asBi-partite Graph
  78. 78. 83kHealth - TechnologyExplanation: is the act of choosing the objects or events that bestaccount for a set of observations; often referred to as hypothesisbuildingDiscrimination: is the act of finding those properties that, ifobserved, would help distinguish between multiple explanatoryfeatures
  79. 79. 84kHealth - TechnologyExplanatory Feature: a feature that explains the set ofobserved propertiesExplanatoryFeature ≡ ∃ssn:isPropertyOf—.{p1} ⊓ … ⊓ ∃ssn:isPropertyOf—.{pn}elevated blood pressureclammy skinpalpitationsHypertensionHyperthyroidismPulmonary EdemaObserved Property Explanatory FeatureExplanation
  80. 80. 85kHealth - TechnologyDiscriminationExpected Property: would be explained by every explanatoryfeatureExpectedProperty ≡ ∃ssn:isPropertyOf.{f1} ⊓ … ⊓ ∃ssn:isPropertyOf.{fn}elevated blood pressureclammy skinpalpitationsHypertensionHyperthyroidismPulmonary EdemaExpected Property Explanatory Feature
  81. 81. 86kHealth - TechnologyDiscriminationNot Applicable Property: would not be explained by anyexplanatory featureNotApplicableProperty ≡ ¬∃ssn:isPropertyOf.{f1} ⊓ … ⊓ ¬∃ssn:isPropertyOf.{fn}elevated blood pressureclammy skinpalpitationsHypertensionHyperthyroidismPulmonary EdemaNot Applicable Property Explanatory Feature
  82. 82. 87kHealth - TechnologyDiscriminationDiscriminating Property: is neither expected nor not-applicableDiscriminatingProperty ≡ ¬ExpectedProperty ⊓ ¬NotApplicablePropertyelevated blood pressureclammy skinpalpitationsHypertensionHyperthyroidismPulmonary EdemaDiscriminating Property Explanatory Feature
  83. 83. 90kHealth DemoAn Ontological Approach to Focusing Attention and Enhancing Machine Perception on the Web, Applied Ontology 2011Representation of Parsimonious Covering Theory in OWL-DL (OWLED 2011)An Efficient Bit Vector Approach to Semantics-based Machine Perception in Resource-Constrained Devices (ISWC 2012)Data Driven Knowledge Acquisition Method for Domain Knowledge Enrichment in Healthcare, BIBM 2012
  84. 84. 91kHealth
  85. 85. 92kHealth - Asthma• Can we detect asthma/allergy early?– Using data from on-body sensors, and environmental sensors– Using knowledge from an asthma ontology, generated from asthma knowledge onthe Web and domain experts– Generate a risk measure from collected data and background knowledge• Can we characterize asthma/allergy progression?– State of asthma patient may change over time– Identifying risky progressions before worsening of the patient state• Does the early detection of asthma/allergy, andsubsequent intervention/treatment, lead toimproved outcomes?– Improved outcomes could be improved health (less serious symptoms), less needfor invasive treatments, preventive measures (e.g. avoiding risky environmentalconditions), less cost, etc.
  86. 86. • GO (well controlled)– peak flow 80-100%*– Good breathing and sleep: Acceleration reading pattern– No cough: microphone– Good physical activity: Acceleration reading pattern• CAUTION (not well controlled)– peak flow 60-80%*– Cough and Wheeze: microphone– Tight chest: Acceleration readings– Wakes up at night: Acceleration reading pattern• STOP (poor control)– peak flow < 60%*– Medicine not helping: medicine = TRUE and still in STOP state– Breathing hard and fast: microphone– Can’t walk or talk well: Acceleration and microphone93* Measured using peak flow meterAsthma Control Level andCorresponding Sensor Observations
  87. 87. 94Physical Socialhttp://ngs.ics.uci.edu/blog/?p=1478CyberData CollectionAnalysisActionTake Medication before going to workAvoid going out in the evening due to high pollen levelsDomain ExpertsDomain KnowledgeRisk ModelAction ModelOverall Landscape
  88. 88. 95PersonalLevel EventsPopulation LevelEvents(Personal Level Events)(Personalized Events) (Population Level Events)Population-levelEvents Relevant atthe Personal-levelMachine sensors: Pollen levels Pollution levels Accelerometer Peak flow meter Medication trackingPersonal sensors: Symptoms(kHealth) (EventShop)Qualify & Quantify-Detect all the factorsinfluencing asthma-Find the role of eachfactor in influencingasthmaAsthma Risk Profile-Contextual informationto personalize risk-Risk score computationAsthma Mitigation-Corrective action basedon risk scoreWhat are the factors influencing my asthma?What is the contribution of each of these factors?How controlled is my asthma? (risk score)What will be my action plan to manage asthma?StoragePose QuestionsReceive answersAccess/update patientinformationMachine sensors: Pollen levels Pollution levelsPersonal sensors: Symptoms Asthma prevalence
  89. 89. 96Community SpacesPersonal SpacesPersonalWheeze – YesDo you have tightness of chest? –YesObservationsPhysical-Cyber-Social System Health Signal Extraction Health Signal Understanding<Wheezing=Yes, time, location><ChectTightness=Yes, time, location><PollenLevel=Medium, time, location><Pollution=Yes, time, location><Activity=High, time, location>WheezingChectTightnessPollenLevelPollutionActivityWheezingChectTightnessPollenLevelPollutionActivityRiskCategory<PollenLevel, ChectTightness, Pollution,Activity, Wheezing, RiskCategory><2, 1, 1,3, 1, RiskCategory><2, 1, 1,3, 1, RiskCategory><2, 1, 1,3, 1, RiskCategory><2, 1, 1,3, 1, RiskCategory>...Actionable InformationAction: contact doctor nowExplanation: Increased activity is the primary cause of wheezing and high risk categoryExpert KnowledgeBackground Knowledgetweet reporting pollution leveland asthma attacksAcceleration readings fromon-phone sensorsSensor and personal observations Signals from personal, personalspaces, and community spacesRisk Category assigned by doctorsQualifyQuantifyEnrichOutdoor pollen and pollution
  90. 90. • Collaborators: AHC (Dr. Agrawal), CITAR-WSU, ezDI(ezdi.us), NLM (Dr. Bodenrider), CTEGD-UGA (Dr.Mnning/Prof. Tarleton), NCBO - Stanford, WelcomeTrust, AFRL, Boonshoft Sch of Med – WSU (Dr. Forbis,…),• Funding: NIH (NHLBI R01: 1R01HL087795-01A1;NIDA: R21 DA030571 ), NSF, AFRL, Industry….Acknowledgements
  91. 91. Thank YouVisit Us @www.knoesis.orgwith additional background at http://knoesis.org/amit/hcls
  92. 92. Ohio Center of Excellence in Knowledge-enabled Computing -An Ohio Center of Excellence in BioHealth InnovationWright State University
  93. 93. Amit Sheth’sPHD studentsAshutosh JadhavHemantPurohitVinhNguyenLu ChenPavanKapanipathiPramodAnantharamSujanPereraAlan SmithPramod KoneruMaryam PanahiazarSarasi LalithsenaCory HensonKalpaGunaratnaDelroyCameronSanjayaWijeratneWenboWangKno.e.sis in 2012 = ~100 researchers (15 faculty, ~50 PhD students)

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