2013
Authors
Cruz Correia, R; Boldt, I; Lapao, L; Santos Pereira, C; Rodrigues, PP; Ferreira, AM; Freitas, A;
Publication
BMC MEDICAL INFORMATICS AND DECISION MAKING
Abstract
Background: Audit Trails (AT) are fundamental to information security in order to guarantee access traceability but can also be used to improve Health information System's (HIS) quality namely to assess how they are used or misused. This paper aims at analysing the existence and quality of AT, describing scenarios in hospitals and making some recommendations to improve the quality of information. Methods: The responsibles of HIS for eight Portuguese hospitals were contacted in order to arrange an interview about the importance of AT and to collect audit trail data from their HIS. Five institutions agreed to participate in this study; four of them accepted to be interviewed, and four sent AT data. The interviews were performed in 2011 and audit trail data sent in 2011 and 2012. Each AT was evaluated and compared in relation to data quality standards, namely for completeness, comprehensibility, traceability among others. Only one of the AT had enough information for us to apply a consistency evaluation by modelling user behaviour. Results: The interviewees in these hospitals only knew a few AT (average of 1 AT per hospital in an estimate of 21 existing HIS), although they all recognize some advantages of analysing AT. Four hospitals sent a total of 7 AT - 2 from Radiology Information System (RIS), 2 from Picture Archiving and Communication System (PACS), 3 from Patient Records. Three of the AT were understandable and three of the AT were complete. The AT from the patient records are better structured and more complete than the RIS/PACS. Conclusions: Existing AT do not have enough quality to guarantee traceability or be used in HIS improvement. Its quality reflects the importance given to them by the CIO of healthcare institutions. Existing standards (e.g. ASTM: E2147, ISO/TS 18308: 2004, ISO/IEC 27001: 2006) are still not broadly used in Portugal.
2013
Authors
Dias, CC; Rodrigues, PP; da Costa Pereira, A; Magro, F;
Publication
WORLD JOURNAL OF GASTROENTEROLOGY
Abstract
AIM: To identify demographic and clinical factors associated with disabling Crohn's disease (CD). METHODS: A systematic review and meta-analysis of observational studies, focusing on the factors that can predict the prognosis of different outcomes of CD was undertaken. PubMed, ISI Web of Knowledge and Scopus were searched to identify studies investigating the above mentioned factors in adult patients with CD. Studies were eligible for inclusion if they describe prognostic factors in CD, with inclusion and exclusion criteria defined as follows. Studies with adult patients and CD, written in English and studying association between clinical factors and at least one prognosis outcome were included. Meta-analysis of effects was undertaken for the disabling disease outcome, using odds ratio (OR) to assess the effect of the different factors in the outcome. The statistical method used was MantelHaenszel for fixed effects. The 16-item quality assessment tool (QATSDD) was used to assess the quality of the studies (range: 0-42). RESULTS: Of the 913 papers initially selected, sixty studies were reviewed and three were included in the systematic review and meta-analysis. The global QATSDD scores of papers were 18, 21 and 22. Of a total of 1961 patients enrolled, 1332 (78%) were classified with disabling disease five years after diagnosis. In two studies, age at diagnosis was a factor associated with disabling disease five years after diagnosis. Individuals under 40 years old had a higher risk of developing disabling disease. In two studies, patients who were treated with corticosteroids on the first flare developed disabling disease five years after diagnosis. Further, perianal disease was found to be relevant in all of the studies at two and five years after diagnosis. Finally, one study showed localization as a factor associated with disabling disease five years after diagnosis, with L3 being a higher risk factor. This meta-analysis showed a significantly higher risk of developing disabling disease at five years after initial diagnosis among patients younger than 40 years of age (OR = 2.47, 95% CI: 1.74-3.51), with initial steroid treatment for first flare (OR = 2.42, 95% CI: 1.87-3.11) and with perianal disease (OR = 2.00, 95% CI: 1.41-2.85). CONCLUSION: Age at diagnosis, perianal disease, initial use of steroids and localization seem to be independent prognostic factors of disabling disease.
2013
Authors
Cardoso, T; Teixeira Pinto, A; Rodrigues, PP; Aragao, I; Costa Pereira, A; Sarmento, AE;
Publication
PLOS ONE
Abstract
Purpose: To develop a clinical staging system based on the PIRO concept (Predisposition, Infection, Response and Organ dysfunction) for hospitalized patients with infection. Methods: One year prospective cohort study of all hospitalized patients with infection (n = 1035), admitted into a large tertiary care, university hospital. Variables associated with hospital mortality were selected using logistic regressions. Based on the regression coefficients, a score for each PIRO component was developed and a classification tree was used to stratify patients into four stages of increased risk of hospital mortality. The final clinical staging system was then validated using an independent cohort (n = 186). Results: Factors significantly associated with hospital mortality were . for Predisposition: age, sex, previous antibiotic therapy, chronic hepatic disease, chronic hematologic disease, cancer, atherosclerosis and a Karnofsky index, 70; . for Insult/Infection: type of infection . for Response: abnormal temperature, tachypnea, hyperglycemia and severity of infection and . for Organ dysfunction: hypotension and SOFA score >= 1. The area under the ROC curve (CI95%) for the combined PIRO model as a predictor for mortality was 0.85 (0.82-0.88). Based on the scores for each of the PIRO components and on the cut-offs estimated from the classification tree, patients were stratified into four stages of increased mortality rates: stage I: <= 5%, stage II: 6-20%, stage III: 21-50% and stage IV: >50%. Finally, this new clinical staging system was studied in a validation cohort, which provided similar results (0%, 9%, 31% and 67%, in each stage, respectively). Conclusions: Based on the PIRO concept, a new clinical staging system was developed for hospitalized patients with infection, allowing stratification into four stages of increased mortality, using the different scores obtained in Predisposition, Response, Infection and Organ dysfunction. The proposed system will likely help to define inclusion criteria in clinical trials as well as tailoring individual management plans for patients with infection.
2013
Authors
Cordeiro, J; Dias, G; Brazdil, P;
Publication
PROGRESS IN ARTIFICIAL INTELLIGENCE, EPIA 2013
Abstract
Sentence Reduction has recently received a great attention from the research community of Automatic Text Summarization. Sentence Reduction consists in the elimination of sentence components such as words, part-of-speech tags sequences or chunks without highly deteriorating the information contained in the sentence and its grammatical correctness. In this paper, we present an unsupervised scalable methodology for learning sentence reduction rules. Paraphrases are first discovered within a collection of automatically crawled Web News Stories and then textually aligned in order to extract interchangeable text fragment candidates, in particular reduction cases. As only positive examples exist, Inductive Logic Programming (ILP) provides an interesting learning paradigm for the extraction of sentence reduction rules. As a consequence, reduction cases are transformed into first order logic clauses to supply a massive set of suitable learning instances and an ILP learning environment is defined within the context of the Aleph framework. Experiments evidence good results in terms of irrelevancy elimination, syntactical correctness and reduction rate in a real-world environment as opposed to other methodologies proposed so far.
2013
Authors
Campos, P; Brazdil, P; Mota, I;
Publication
COMPUTATIONAL ECONOMICS
Abstract
In this work we analyze the evolving dynamics of different strategies of collaborative networks that emerge from the creation and diffusion of knowledge. An evolutionary economic approach is adopted by introducing decision rules that are applied routinely and an agent-based model is developed. Firms (the agents) can collaborate and create networks for research and development purposes. We have compared three collaboration strategies (A-peer-to-peer complementariness, B-concentration process and C-virtual cooperation networks) that were defined on the basis of literature and on empirical evidence. Strategies are introduced exogenously in the simulation. The aims of this paper are twofold: (i) to analyze the importance of the networking effects; and (ii) to test the differences among collaboration strategies. It was possible to conclude that profit is associated with higher stock of knowledge and with smaller network diameter. In addition, concentration strategies are more profitable and more efficient in transmitting knowledge through the network. These processes reinforce the stock of knowledge and the profit of the firms located in the centers of the networks.
2013
Authors
Stoyanova, J; Gonçalves, R; Brito, PQ; Coelho, A;
Publication
Int. J. Online Biomed. Eng.
Abstract
The present-day revival of Augmented reality (AR) technology has led to its vast expansion in various applications. In marketing, the hunt for more inventive and intriguing approaches for immersive consumer experiences has endorsed the implementation of AR in multiple brand advertising campaigns, specifically for improved product display. The engaging potential of this technology is established in the fusion between computer-generated data and the physical world as seen by the user, where 3D registration and real time interaction are inseparable parts of this system. Alternatively, impressions from user experiences serve as a principal instrument in the evaluation process of the effectiveness of interactive systems. In order to get deeper insight into consumers' reflections from a real-time AR shopping experience, we present a demo platform for the purchase of sneakers, focusing on users' behavior and more precisely on their perceptions, emotions, personal preferences before, during and after use of the platform. To fully evaluate and compare consumer experiences with the main AR platform, two other shopping systems were designed: a marker-based and a static one. Consecutively, we aim at defining a system of metrics for measuring shopping experiences with AR, as well as at establishing a ground base for subsequent marketing research in the field. Motivated by the large application of the technology and aiming at understanding the impact of AR on consumer psychology, the application will assist in exploring the antecedents of consumer purchase intentions.
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