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Description
Medical students acquire and enhance their clinical skills using various available techniques and resources. As the health care profession has move towards team-based practice, students and trainees need to practice team-based procedures that involve timely management of clinical tasks and adequate communication with other members of the team. Such team-based

Medical students acquire and enhance their clinical skills using various available techniques and resources. As the health care profession has move towards team-based practice, students and trainees need to practice team-based procedures that involve timely management of clinical tasks and adequate communication with other members of the team. Such team-based procedures include surgical and clinical procedures, some of which are protocol-driven. Cost and time required for individual team-based training sessions, along with other factors, contribute to making the training complex and challenging. A great deal of research has been done on medically-focused collaborative virtual reality (VR)-based training for protocol-driven procedures as a cost-effective as well as time-efficient solution. Most VR-based simulators focus on training of individual personnel. The ones which focus on providing team training provide an interactive simulation for only a few scenarios in a collaborative virtual environment (CVE). These simulators are suited for didactic training for cognitive skills development. The training sessions in the simulators require the physical presence of mentors. The problem with this kind of system is that the mentor must be present at the training location (either physically or virtually) to evaluate the performance of the team (or an individual). Another issue is that there is no efficient methodology that exists to provide feedback to the trainees during the training session itself (formative feedback). Furthermore, they lack the ability to provide training in acquisition or improvement of psychomotor skills for the tasks that require force or touch feedback such as cardiopulmonary resuscitation (CPR). To find a potential solution to overcome some of these concerns, a novel training system was designed and developed that utilizes the integration of sensors into a CVE for time-critical medical procedures. The system allows the participants to simultaneously access the CVE and receive training from geographically diverse locations. The system is also able to provide real-time feedback and is also able to store important data during each training/testing session. Finally, this study also presents a generalizable collaborative team-training system that can be used across various team-based procedures in medical as well as non-medical domains.
ContributorsKhanal, Prabal (Author) / Greenes, Robert (Thesis advisor) / Patel, Vimla (Thesis advisor) / Smith, Marshall (Committee member) / Gupta, Ashish (Committee member) / Kaufman, David (Committee member) / Arizona State University (Publisher)
Created2014
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Description
A core principle in multiple national quality improvement strategies is the engagement of chronically ill patients in the creation and execution of their treatment plans. Numerous initiatives are underway to use health information technology (HIT) to support patient engagement however the use of HIT and other factors such as health

A core principle in multiple national quality improvement strategies is the engagement of chronically ill patients in the creation and execution of their treatment plans. Numerous initiatives are underway to use health information technology (HIT) to support patient engagement however the use of HIT and other factors such as health literacy may be significant barriers to engagement for older adults. This qualitative descriptive study sought to explore the ways that older adults with multi-morbidities engaged with their plan of care. Forty participants were recruited through multiple case sampling from two ambulatory cardiology practices. Participants were English-speaking, without a dementia-related diagnosis, and between the ages of 65 and 86. The older adults in this study performed many behaviors to engage in the plan of care, including acting in ways to support health, managing health-related information, attending routine visits with their doctors, and participating in treatment planning. A subset of patients engaged in active decision-making because of the point they were at in their chronic disease. At that cross roads, they expressed uncertainly over which road to travel. Two factors influenced the engagement of older adults: a relationship with the provider that met the patient's needs, and the distribution of a Meaningful Use clinical summary at the conclusion of the provider visit. Participants described the ways in which the clinical summary helped and hindered their understanding of the care plan.

Insights gained as a result of this study include an understanding of the discrepancies between what the healthcare system expects of patients and their actual behavior when it comes to the creation of a care plan and the ways in which they take care of their health. Further research should examine the ability of various factors to enhance patient engagement. For example, it may be useful to focus on ways to improve the clinical summary to enhance engagement with the care plan and meet standards for a health literate document. Recommendations for the improvement of the clinical summary are provided. Finally, this study explored potential reasons for the infrequent use of online health information by older adults including the trusting relationship they enjoyed with their cardiologist.
ContributorsJiggins Colorafi, Karen (Author) / Lamb, Gerri (Thesis advisor) / Marek, Karen (Committee member) / Greenes, Robert (Committee member) / Evans, Bronwynne (Committee member) / Arizona State University (Publisher)
Created2015
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Description
In this dissertation, two interrelated problems of service-based systems (SBS) are addressed: protecting users' data confidentiality from service providers, and managing performance of multiple workflows in SBS. Current SBSs pose serious limitations to protecting users' data confidentiality. Since users' sensitive data is sent in unencrypted forms to remote machines owned

In this dissertation, two interrelated problems of service-based systems (SBS) are addressed: protecting users' data confidentiality from service providers, and managing performance of multiple workflows in SBS. Current SBSs pose serious limitations to protecting users' data confidentiality. Since users' sensitive data is sent in unencrypted forms to remote machines owned and operated by third-party service providers, there are risks of unauthorized use of the users' sensitive data by service providers. Although there are many techniques for protecting users' data from outside attackers, currently there is no effective way to protect users' sensitive data from service providers. In this dissertation, an approach is presented to protecting the confidentiality of users' data from service providers, and ensuring that service providers cannot collect users' confidential data while the data is processed or stored in cloud computing systems. The approach has four major features: (1) separation of software service providers and infrastructure service providers, (2) hiding the information of the owners of data, (3) data obfuscation, and (4) software module decomposition and distributed execution. Since the approach to protecting users' data confidentiality includes software module decomposition and distributed execution, it is very important to effectively allocate the resource of servers in SBS to each of the software module to manage the overall performance of workflows in SBS. An approach is presented to resource allocation for SBS to adaptively allocating the system resources of servers to their software modules in runtime in order to satisfy the performance requirements of multiple workflows in SBS. Experimental results show that the dynamic resource allocation approach can substantially increase the throughput of a SBS and the optimal resource allocation can be found in polynomial time
ContributorsAn, Ho Geun (Author) / Yau, Sik-Sang (Thesis advisor) / Huang, Dijiang (Committee member) / Ahn, Gail-Joon (Committee member) / Santanam, Raghu (Committee member) / Arizona State University (Publisher)
Created2012
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Description
Social media is becoming increasingly popular as a platform for sharing personal health-related information. This information can be utilized for public health monitoring tasks such as pharmacovigilance via the use of Natural Language Processing (NLP) techniques. One of the critical steps in information extraction pipelines is Named Entity Recognition

Social media is becoming increasingly popular as a platform for sharing personal health-related information. This information can be utilized for public health monitoring tasks such as pharmacovigilance via the use of Natural Language Processing (NLP) techniques. One of the critical steps in information extraction pipelines is Named Entity Recognition (NER), where the mentions of entities such as diseases are located in text and their entity type are identified. However, the language in social media is highly informal, and user-expressed health-related concepts are often non-technical, descriptive, and challenging to extract. There has been limited progress in addressing these challenges, and advanced machine learning-based NLP techniques have been underutilized. This work explores the effectiveness of different machine learning techniques, and particularly deep learning, to address the challenges associated with extraction of health-related concepts from social media. Deep learning has recently attracted a lot of attention in machine learning research and has shown remarkable success in several applications particularly imaging and speech recognition. However, thus far, deep learning techniques are relatively unexplored for biomedical text mining and, in particular, this is the first attempt in applying deep learning for health information extraction from social media.

This work presents ADRMine that uses a Conditional Random Field (CRF) sequence tagger for extraction of complex health-related concepts. It utilizes a large volume of unlabeled user posts for automatic learning of embedding cluster features, a novel application of deep learning in modeling the similarity between the tokens. ADRMine significantly improved the medical NER performance compared to the baseline systems.

This work also presents DeepHealthMiner, a deep learning pipeline for health-related concept extraction. Most of the machine learning methods require sophisticated task-specific manual feature design which is a challenging step in processing the informal and noisy content of social media. DeepHealthMiner automatically learns classification features using neural networks and utilizing a large volume of unlabeled user posts. Using a relatively small labeled training set, DeepHealthMiner could accurately identify most of the concepts, including the consumer expressions that were not observed in the training data or in the standard medical lexicons outperforming the state-of-the-art baseline techniques.
ContributorsNikfarjam, Azadeh (Author) / Gonzalez, Graciela (Thesis advisor) / Greenes, Robert (Committee member) / Scotch, Matthew (Committee member) / Arizona State University (Publisher)
Created2016
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Description
Parkinson's disease, the most prevalent movement disorder of the central nervous system, is a chronic condition that affects more than 1000,000 U.S. residents and about 3% of the population over the age of 65. The characteristic symptoms include tremors, bradykinesia, rigidity and impaired postural stability. Current therapy based on augmentation

Parkinson's disease, the most prevalent movement disorder of the central nervous system, is a chronic condition that affects more than 1000,000 U.S. residents and about 3% of the population over the age of 65. The characteristic symptoms include tremors, bradykinesia, rigidity and impaired postural stability. Current therapy based on augmentation or replacement of dopamine is designed to improve patients' motor performance but often leads to levodopa-induced complications, such as dyskinesia and motor fluctuation. With the disease progress, clinicians must closely monitor patients' progress in order to identify any complications or decline in motor function as soon as possible in PD management. Unfortunately, current clinical assessment for Parkinson's is subjective and mostly influenced by brief observations during patient visits. Thus improvement or decline in patients' motor function in between visits is extremely difficult to assess. This may hamper clinicians while making informed decisions about the course of therapy for Parkinson's patients and could negatively impact clinical care. In this study we explored new approaches for PD assessment that aim to provide home-based PD assessment and monitoring. By extending the disease assessment to home, the healthcare burden on patients and their family can be reduced, and the disease progress can be more closely monitored by physicians. To achieve these aims, two novel approaches have been designed, developed and validated. The first approach is a questionnaire based self-evaluation metric, which estimate the PD severity through using self-evaluation score on pre-designed questions. Based on the results of the first approach, a smart phone based approach was invented. The approach takes advantage of the mobile computing technology and clinical decision support approach to evaluate the motor performance of patient daily activity and provide the longitudinal disease assessment and monitoring. Both approaches have been validated on recruited PD patients at the movement disorder program of Barrow Neurological Clinic (BNC) at St Joseph's Hospital and Medical Center. The results of validation tests showed favorable accuracy on detecting and assessing critical symptoms of PD, and shed light on promising future of implementing mobile platform based PD evaluation and monitoring tools to facilitate PD management.
ContributorsPan, Di (Author) / Petitti, Diana (Thesis advisor) / Greenes, Robert (Committee member) / Johnson, William (Committee member) / Dhall, Rohit (Committee member) / Arizona State University (Publisher)
Created2013
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Description
Unstructured texts containing biomedical information from sources such as electronic health records, scientific literature, discussion forums, and social media offer an opportunity to extract information for a wide range of applications in biomedical informatics. Building scalable and efficient pipelines for natural language processing and extraction of biomedical information plays an

Unstructured texts containing biomedical information from sources such as electronic health records, scientific literature, discussion forums, and social media offer an opportunity to extract information for a wide range of applications in biomedical informatics. Building scalable and efficient pipelines for natural language processing and extraction of biomedical information plays an important role in the implementation and adoption of applications in areas such as public health. Advancements in machine learning and deep learning techniques have enabled rapid development of such pipelines. This dissertation presents entity extraction pipelines for two public health applications: virus phylogeography and pharmacovigilance. For virus phylogeography, geographical locations are extracted from biomedical scientific texts for metadata enrichment in the GenBank database containing 2.9 million virus nucleotide sequences. For pharmacovigilance, tools are developed to extract adverse drug reactions from social media posts to open avenues for post-market drug surveillance from non-traditional sources. Across these pipelines, high variance is observed in extraction performance among the entities of interest while using state-of-the-art neural network architectures. To explain the variation, linguistic measures are proposed to serve as indicators for entity extraction performance and to provide deeper insight into the domain complexity and the challenges associated with entity extraction. For both the phylogeography and pharmacovigilance pipelines presented in this work the annotated datasets and applications are open source and freely available to the public to foster further research in public health.
ContributorsMagge, Arjun (Author) / Scotch, Matthew (Thesis advisor) / Gonzalez-Hernandez, Graciela (Thesis advisor) / Greenes, Robert (Committee member) / Arizona State University (Publisher)
Created2019