Modelling and assessing one- and two-drug dose titrations.

In health-care, there is a need to quantify medical errors. Among these errors, we observe wrong dose prescriptions. Drug dose titration (DT) is the process by which dosage is progressively adjusted to the patient till a steady dose is reached. Depending on the clinical disease, drug, and patient condition, dose titration can follow different procedures. Once modeled, these procedures can serve for clinical homogenization, standardization, decision support and retrospective analysis. Here, we propose a language to model dose titration procedures. The language was used to formalize one- and two-drug titration of chronic and acute cases, and to perform retrospective analysis of the drug titration processes on 253 patients diagnosed of diabetes mellitus type 2 and treated with metformin, 321 patients treated of chonic heart failure with furosemide, 155 patients with hyperuricemia treated with allopurinol as initial drug and febuxostat as alternative drug, and 187 hyperuricemia patients with primary drug allopurinol and supplementary drug probenecid, in order to identify different types of drug titration deviations from standard DT methods.

A Model of Perception of Privacy, Trust, and Self-Disclosure on Online Social Networks.

Online Social Networks are used widely, raising new issues in terms of privacy, trust, and self-disclosure. For a better understanding of these issues for Facebook users, a model was built that includes privacy value, privacy risk, trust, privacy control, privacy concerns, and self-disclosure. A total of 602 respondents participated in an online survey, and structural equation modeling was used to evaluate the model. The findings indicate significant relationships between the constructs in this study. The model from our study contributes new knowledge to privacy issues, trust and self-disclosure on Online Social Networks for other researchers or developers of online social networks.

Knowledge Formalization to Support Decision-Making in Heart Failure Treatment.

This paper presents medical knowledge representation of data provided within Clinical Practice Guidelines for Heart Failure. The formalization is provided in order to support taking decisions on an appropriate treatment strategy for a specific patient. An intuitive and efficient mechanism of medical knowledge formalization, called extended Timed Transition Diagram (eTTD), is used to represent acquired medical knowledge. The presented models can be used to help students in their training as well as to support physicians with their decision-making tasks.

Sensors and Functionalities of Non-Invasive Wrist-Wearable Devices: A Review.

Wearable devices have recently received considerable interest due to their great promise for a plethora of applications. Increased research efforts are oriented towards a non-invasive monitoring of human health as well as activity parameters. A wide range of wearable sensors are being developed for real-time non-invasive monitoring. This paper provides a comprehensive review of sensors used in wrist-wearable devices, methods used for the visualization of parameters measured as well as methods used for intelligent analysis of data obtained from wrist-wearable devices. In line with this, the main features of commercial wrist-wearable devices are presented. As a result of this review, a taxonomy of sensors, functionalities, and methods used in non-invasive wrist-wearable devices was assembled.

Formalization and acquisition of temporal knowledge for decision support in medical processes.

BACKGROUND: In medical practice, long term interventions are common and they require timely planning of the involved processes. Unfortunately, evidence-based statements about time are hard to find in Clinical Practice Guidelines (CPGs) and in other sources of medical knowledge. At the same time, health care centers use medical records and information systems to register data about clinical processes and patients, including time information about the encounters, prescriptions, and other clinical actions. Consequently, medical records and health care information systems are promising sources of data from which we can detect temporal medical knowledge. OBJECTIVE: The objectives were to (1) Analyze and classify the sorts of time constraints in medical processes, (2) Propose a formalism to represent these sorts of clinical time constraints, (3) Use these formalisms to enable the automatic generation of temporal models from clinical data, and (4) Study the adherence of these intervention models to CPG recommendations. METHODS: In order to achieve these objectives, we carried out four studies: The identification of the sort of times involved in the long-term diagnostic and therapeutic medical procedures of fifty patients, the supervision of the indications about time contained in six CPGs on chronic diseases, the study of the time structures of two standard data models, as well as ten languages to computerize CPGs. Based on the provided studies, we synthesized two representation formalisms: Micro- and macro-temporality. We developed three algorithms for automatic generation of generalized time constraints in the form of micro- and macro-temporalities from clinical databases, which were double tested. RESULTS: A full classification of time constraints for medical procedures is proposed. Two formalisms called micro- and macro-temporality are introduced and validated to represent these time constraints. Time constraints were generated automatically from the data about 8781 Arterial Hypertension (AH) patients. The generated macro-temporalities restricted visits to be between 1-7 weeks, whereas CPGs recommend 2-4 weeks. Micro-temporal constraints on drug-dosage therapies distinguished between the initial dosage and the target dosage, with visits every 1-6 weeks, and 2-5 months, respectively. Our algorithms obtained semi-complete maps of dosage increments and the maximum dosages for 7 drug types. Data-based time limits for lifestyle change counsels and blood pressure (BP) check-ups were fixed to 6 and 3 months, for patients with low- and high-BP, respectively, when CPGs specify a general 3-6 month range. CONCLUSIONS: Experience-based temporal knowledge detected using our algorithms complements the evidence-based knowledge about clinical procedures contained in the CPGs. Our temporal model is simple and highly descriptive when dealing with general or specific time constraints' representations, offering temporal knowledge representation of varying detail. Therefore, it is capable of capturing all the temporal knowledge we can find in medical procedures, when dealing with chronic diseases. With our model and algorithms, an adherence analysis emerges naturally to detect CPG-compliant interventions, but also deviations whose causes and possible rationales can call into question CPG recommendations (e.g., our analysis of AH patients showed that the time between visits recommended by CPGs were too long for a proper drug therapy decision, dosage titration, or general follow-up).

Patient education on safety and privacy.

The individual's right to determine if, when and how data about them will be collected, stored, used and shared with others is called the right to privacy. The problem of data collection and sharing arises daily among health services. Among medical staff, there are numerous message flows, including the medical records of patients and other patient's personal data. These data are often completely unprotected and available to anyone who knows where it is. Unfortunately, the same data might not be available for patients, despite the fact that each individual has the right to view their own medical record and despite the fact that many other persons connected directly or indirectly to the patient has this access without limitations. In the paper, we will not concentrate on actions that medical staff has to perform nor on the knowledge that they have to have in order to protect a patient's personal data and enable a patient's access to their own data, but we will concentrate on the problem of educating patients about their rights and duties with regard to safety and privacy. Our educational suggestions will be given on the basis of corresponding Slovenian legislation and guidelines for medical staff regarding the protection of personal data.