Support System for Early Diagnosis of Chronic Obstructive Pulmonary Disease Based on the Service-Oriented Architecture Paradigm and Business Process Management Strategy: Development and Usability Survey Among Patients and Health Care Providers.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease with a high global prevalence. The main scientific societies dedicated to the management of this disease have published clinical practice guidelines for quality practice. However, at present, there are important weaknesses in COPD diagnosis criteria that often lead to underdiagnosis or misdiagnosis. OBJECTIVE: We sought to develop a new support system for COPD diagnosis. The system was designed to overcome the weaknesses detected in current guidelines with the goals of enabling early diagnosis, and improving the diagnostic accuracy and quality of care provided. METHODS: We first analyzed the main clinical guidelines for COPD to detect weaknesses that exist in the current diagnostic process, and then proposed a redesign based on a business process management (BPM) strategy for its optimization. The BPM system acts as a backbone throughout the process of COPD diagnosis in this proposed approach. The newly developed support system was integrated into a health information system for validation of its use in a hospital environment. The system was qualitatively evaluated by experts (n=12) and patients (n=36). RESULTS: Among the 12 experts, 10 (83%) positively evaluated our system with respect to increasing the speed for making the diagnosis, helping in interpreting results, and encouraging opportunistic diagnosis. With an overall rating of 4.29 on a 5-point scale, 27/36 (75%) of patients considered that the system was very useful in providing a warning about possible cases of COPD. The overall assessment of the system was 4.53 on a 5-point Likert scale with agreement to extend its use to all primary care centers. CONCLUSIONS: The proposed system provides a functional method to overcome the weaknesses detected in the current diagnostic process for COPD, which can help foster early diagnosis, while improving the diagnostic accuracy and quality of care provided.

A Secure Multi-Tier Mobile Edge Computing Model for Data Processing Offloading Based on Degree of Trust.

Current mobile devices need to run applications with high computational demands and critical response times. The mobile edge computing (MEC) paradigm was developed to improve the performance of these devices. This new computation architecture allows for the mobile devices to execute applications on fog nodes at the network edge; this process is called data processing offloading. This article presents a security model for the externalization of application execution in multi-tier MEC environments. The principal novelty of this study is that the model is able to modify the required security level in each tier of the distributed architecture as a function of the degree of trust associated with that tier. The basic idea is that a higher degree of trust requires a lower level of security, and vice versa. A formal framework is introduced that represents the general environment of application execution in distributed MEC architectures. An architecture is proposed that allows for deployment of the model in production environments and is implemented for evaluation purposes. The results show that the security model can be applied in multi-tier MEC architectures and that the model produces a minimal overhead, especially for computationally intensive applications.

A Distributed Model for Stressors Monitoring Based on Environmental Smart Sensors.

Nowadays, in many countries, stress is becoming a problem that increasingly affects the health of people. Suffering stress continuously can lead to serious behavioral disorders such as anxiety or depression. Every person, in his daily routine, can face many factors which can contribute to increase his stress level. This paper describes a flexible and distributed model to monitor environmental variables associated with stress, which provides adaptability to any environment in an agile way. This model was designed to transform stress environmental variables in value added information (key stress indicator) and to provide it to external systems, in both proactive and reactive mode. Thus, this value-added information will assist organizations and users in a personalized way helping in the detection and prevention of acute stress cases. Our proposed model is supported by an architecture that achieves the features above mentioned, in addition to interoperability, robustness, scalability, autonomy, efficient, low cost and consumption, and information availability in real time. Finally, a prototype of the system was implemented, allowing the validation of the proposal in different environments at the University of Alicante.

A Context-Driven Model for the Flat Roofs Construction Process through Sensing Systems, Internet-of-Things and Last Planner System.

The main causes of building defects are errors in the design and the construction phases. These causes related to construction are mainly due to the general lack of control of construction work and represent approximately 75% of the anomalies. In particular, one of the main causes of such anomalies, which end in building defects, is the lack of control over the physical variables of the work environment during the execution of tasks. Therefore, the high percentage of defects detected in buildings that have the root cause in the construction phase could be avoidable with a more accurate and efficient control of the process. The present work proposes a novel integration model based on information and communications technologies for the automation of both construction work and its management at the execution phase, specifically focused on the flat roof construction process. Roofs represent the second area where more defects are claimed. The proposed model is based on a Web system, supported by a service oriented architecture, for the integral management of tasks through the Last Planner System methodology, but incorporating the management of task restrictions from the physical environment variables by designing specific sensing systems. Likewise, all workers are integrated into the management process by Internet-of-Things solutions that guide them throughout the execution process in a non-intrusive and transparent way.

Empowerment of Patients with Hypertension through BPM, IoT and Remote Sensing.

Hypertension affects one in five adults worldwide. Healthcare processes require interdisciplinary cooperation and coordination between medical teams, clinical processes, and patients. The lack of patients' empowerment and adherence to treatment makes necessary to integrate patients, data collecting devices and clinical processes. For this reason, in this paper we propose a model based on Business Process Management paradigm, together with a group of technologies, techniques and IT principles which increase the benefits of the paradigm. To achieve the proposed model, the clinical process of the hypertension is analyzed with the objective of detecting weaknesses and improving the process. Once the process is analyzed, an architecture that joins health devices and environmental sensors, together with an information system, has been developed. To test the architecture, a web system connected with health monitors and environment sensors, and with a mobile app have been implemented.

Monitoring-Based Model for Personalizing the Clinical Process of Crohn's Disease.

Crohn's disease is a chronic pathology belonging to the group of inflammatory bowel diseases. Patients suffering from Crohn's disease must be supervised by a medical specialist for the rest of their lives; furthermore, each patient has its own characteristics and is affected by the disease in a different way, so health recommendations and treatments cannot be generalized and should be individualized for a specific patient. To achieve this personalization in a cost-effective way using technology, we propose a model based on different information flows: control, personalization, and monitoring. As a result of the model and to perform a functional validation, an architecture based on services and a prototype of the system has been defined. In this prototype, a set of different devices and technologies to monitor variables from patients and their environment has been integrated. Artificial intelligence algorithms are also included to reduce the workload related to the review and analysis of the information gathered. Due to the continuous and automated monitoring of the Crohn's patient, this proposal can help in the personalization of the Crohn's disease clinical process.

SOA-based model for value-added ITS services delivery.

Integration is currently a key factor in intelligent transportation systems (ITS), especially because of the ever increasing service demands originating from the ITS industry and ITS users. The current ITS landscape is made up of multiple technologies that are tightly coupled, and its interoperability is extremely low, which limits ITS services generation. Given this fact, novel information technologies (IT) based on the service-oriented architecture (SOA) paradigm have begun to introduce new ways to address this problem. The SOA paradigm allows the construction of loosely coupled distributed systems that can help to integrate the heterogeneous systems that are part of ITS. In this paper, we focus on developing an SOA-based model for integrating information technologies (IT) into ITS to achieve ITS service delivery. To develop our model, the ITS technologies and services involved were identified, catalogued, and decoupled. In doing so, we applied our SOA-based model to integrate all of the ITS technologies and services, ranging from the lowest-level technical components, such as roadside unit as a service (RSUAAS), to the most abstract ITS services that will be offered to ITS users (value-added services). To validate our model, a functionality case study that included all of the components of our model was designed.

Analyzing the use of artificial intelligence for the management of chronic obstructive pulmonary disease (COPD).

OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is a disease that causes airflow limitation to the lungs and has a high morbidity around the world. The objective of this study was to evaluate how artificial intelligence (AI) is being applied for the management of the disease, analyzing the objectives that are raised, the algorithms that are used and what results they offer. METHODS: We conducted a scoping review following the Arksey and O'Malley (2005) and Levac et al. (2010) guidelines. Two reviewers independently searched, analyzed and extracted data from papers of five databases: Web of Science, PubMed, Scopus, Cinahl and Cochrane. To be included, the studies had to apply some AI techniques for the management of at least one stage of the COPD clinical process. In the event of any discrepancy between both reviewers, the criterion of a third reviewer prevailed. RESULTS: 380 papers were identified through database searches. After applying the exclusion criteria, 67 papers were included in the study. The studies were of a different nature and pursued a wide range of objectives, highlighting mainly those focused on the identification, classification and prevention of the disease. Neural nets, support vector machines and decision trees were the AI algorithms most commonly used. The mean and median values of all the performance metrics evaluated were between 80% and 90%. CONCLUSIONS: The results obtained show a growing interest in the development of medical applications that manage the different phases of the COPD clinical process, especially predictive models. According to the performance shown, these models could be a useful complementary tool in the decision-making by health specialists, although more high-quality ML studies are needed to endorse the findings of this study.