Recommender Systems for Health Informatics: State-of-the-Art and Future Perspectives

Investigating diseases and chemicals in COVID-19 literature with text mining

Given the rapidly unfolding nature of the COVID-19 pandemic, there is an urgent need to streamline the literature synthesis of the growing scientific research to elucidate targeted solutions. Traditional systematic literature review studies have restrictions, including analyzing a limited number of papers, having various biases, being time-consuming and labor-intensive, focusing on a few topics, and lack of data-driven tools. This research has collected 9298 papers representing COVID-19 research published through May 5, 2020. We used frequency analysis to find highly frequent manifestations and therapeutic chemicals, representing the importance of the two biomedical concepts. This study also applied topic modeling that provided 25 categories showing associations between the two overarching categories. This study is beneficial to researchers for obtaining a macro-level picture of literature, to educators for knowing the scope of literature, and to policymakers and funding agencies for creating scientific strategic plans regarding COVID-19.

Consequential factors of Big Data's Analytics Capability: how firms use data in the competitive scenario

Purpose

The article's objective is to analyze the consequent factors of Big Data Analytics Capability for firms in the competitive scenario, using different analytical models.

Design/methodology/approach

The research had a quantitative approach, using a survey of data from firms located in the state of São Paulo – Brazil. Structural Equation Modeling (SEM) was used to validate the model.

Findings

The results reveal that all hypotheses were accepted. Business value was the construct that had the most explanatory power in the model. It is necessary to invest more in analytical tools, as well as people trained in the analysis of these models, in addition to a change of mindset, which will dictate the bias of the firm's strategic decision-making. The Big Data analysis is evident from firms' growing investments, particularly those that operate in complex and fast-paced environments.

Practical implications

The proposed theoretical model makes it possible to verify firms' analytical structure and whether they are better positioned to analyze customer data and information in real-time, generate insights and implement solutions to maintain and improve their market position.

Originality/value

The contribution of this article is to present a proposal to expand the research models in the literature that analyzed the direct and indirect relationship between “Big Data Analytics Capability” and “Product Innovation Performance”.

Recommender systems in the healthcare domain: state-of-the-art and research issues

Nowadays, a vast amount of clinical data scattered across different sites on the Internet hinders users from finding helpful information for their well-being improvement. Besides, the overload of medical information (e.g., on drugs, medical tests, and treatment suggestions) have brought many difficulties to medical professionals in making patient-oriented decisions. These issues raise the need to apply recommender systems in the healthcare domain to help both, end-users and medical professionals, make more efficient and accurate health-related decisions. In this article, we provide a systematic overview of existing research on healthcare recommender systems. Different from existing related overview papers, our article provides insights into recommendation scenarios and recommendation approaches. Examples thereof are food recommendation, drug recommendation, health status prediction, healthcare service recommendation, and healthcare professional recommendation. Additionally, we develop working examples to give a deep understanding of recommendation algorithms. Finally, we discuss challenges concerning the development of healthcare recommender systems in the future.

Health Recommender Systems: Systematic Review

Background

Health recommender systems (HRSs) offer the potential to motivate and engage users to change their behavior by sharing better choices and actionable knowledge based on observed user behavior.

Objective

We aim to review HRSs targeting nonmedical professionals (laypersons) to better understand the current state of the art and identify both the main trends and the gaps with respect to current implementations.

Methods

We conducted a systematic literature review according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and synthesized the results. A total of 73 published studies that reported both an implementation and evaluation of an HRS targeted to laypersons were included and analyzed in this review.

Results

Recommended items were classified into four major categories: lifestyle, nutrition, general health care information, and specific health conditions. The majority of HRSs use hybrid recommendation algorithms. Evaluations of HRSs vary greatly; half of the studies only evaluated the algorithm with various metrics, whereas others performed full-scale randomized controlled trials or conducted in-the-wild studies to evaluate the impact of HRSs, thereby showing that the field is slowly maturing. On the basis of our review, we derived five reporting guidelines that can serve as a reference frame for future HRS studies. HRS studies should clarify who the target user is and to whom the recommendations apply, what is recommended and how the recommendations are presented to the user, where the data set can be found, what algorithms were used to calculate the recommendations, and what evaluation protocol was used.

Conclusions

There is significant opportunity for an HRS to inform and guide health actions. Through this review, we promote the discussion of ways to augment HRS research by recommending a reference frame with five design guidelines.

Recommender systems in the healthcare domain: state-of-the-art and research issues

Nowadays, a vast amount of clinical data scattered across different sites on the Internet hinders users from finding helpful information for their well-being improvement. Besides, the overload of medical information (e.g., on drugs, medical tests, and treatment suggestions) have brought many difficulties to medical professionals in making patient-oriented decisions. These issues raise the need to apply recommender systems in the healthcare domain to help both, end-users and medical professionals, make more efficient and accurate health-related decisions. In this article, we provide a systematic overview of existing research on healthcare recommender systems. Different from existing related overview papers, our article provides insights into recommendation scenarios and recommendation approaches. Examples thereof are food recommendation, drug recommendation, health status prediction, healthcare service recommendation, and healthcare professional recommendation. Additionally, we develop working examples to give a deep understanding of recommendation algorithms. Finally, we discuss challenges concerning the development of healthcare recommender systems in the future.

Measuring the Quality of Explanations: The System Causability Scale (SCS): Comparing Human and Machine Explanations

Recent success in Artificial Intelligence (AI) and Machine Learning (ML) allow problem solving automatically without any human intervention. Autonomous approaches can be very convenient. However, in certain domains, e.g., in the medical domain, it is necessary to enable a domain expert to understand, why an algorithm came up with a certain result. Consequently, the field of Explainable AI (xAI) rapidly gained interest worldwide in various domains, particularly in medicine. Explainable AI studies transparency and traceability of opaque AI/ML and there are already a huge variety of methods. For example with layer-wise relevance propagation relevant parts of inputs to, and representations in, a neural network which caused a result, can be highlighted. This is a first important step to ensure that end users, e.g., medical professionals, assume responsibility for decision making with AI/ML and of interest to professionals and regulators. Interactive ML adds the component of human expertise to AI/ML processes by enabling them to re-enact and retrace AI/ML results, e.g. let them check it for plausibility. This requires new human–AI interfaces for explainable AI. In order to build effective and efficient interactive human–AI interfaces we have to deal with the question of how to evaluate the quality of explanations given by an explainable AI system. In this paper we introduce our System Causability Scale to measure the quality of explanations. It is based on our notion of Causability (Holzinger et al. in Wiley Interdiscip Rev Data Min Knowl Discov 9(4), 2019) combined with concepts adapted from a widely-accepted usability scale.

Harmonization and Categorization of Metrics and Criteria for Evaluation of Recommender Systems in Healthcare From Dual Perspectives

Researchers' choice of metrics and criteria in evaluating recommender systems depends on what the researcher feels is popular among other researchers, or sometimes based on the objective of the research. There is no harmonized set of criteria and metrics that can be referenced when evaluating recommender systems in healthcare. In this article, a set of metrics and criteria are harmonized and categorized as a guide for evaluating recommender systems. By means of an online survey, the opinions of forty-four experienced researchers and other stakeholders from eight countries and four continents were sought on the relevance of identified metrics and criteria. Analysis of the results show speed and timeliness are at the top. Topping the list of criteria is the provision of information that will guide users to useful decisions. The result is presented from two logical perspectives. Four categories are then identified as a useful guide for evaluating recommender systems.

Recommender systems for IoT enabled quantified-self applications

As an emerging trend in big data science, applications based onthe Quantified-Self (QS)engage individuals in the self-tracking of any kind of biological, physical, behavioral, or environmental information as individuals or groups. There are new needs and opportunities for recommender systems to develop new models/approaches to support QS application users.Recommender systemscan help to more easily identify relevant artifacts for users and thus improve user experiences. Currently recommender systems are widely and effectively used in the e-commerce domain (e.g., online music services, online bookstores). Next-generation QS applications could include more recommender tools for assisting the users of QS systems based on their personal self-tracking data streams from wearable electronics, biosensors, mobile phones, genomic data, and cloud-based services. In this paper, we propose three new recommendation approaches for QS applications:Virtual Coach,Virtual Nurse, andVirtual Sleep Regulatorwhich help QS users to improve their health conditions.Virtual Coachworks like a real fitness coach to recommend personalized work-out plans whereasVirtual Nurseconsiders the medical history and health targets of a user to recommend a suitable physical activity plan.Virtual Sleep Regulatoris specifically designed for insomnia (a kind of sleep disorder) patients to improve their sleep quality with the help of recommended physical activity and sleep plans. We explain how these proposed recommender technologies can be applied on the basis of the collected QS data to create qualitative recommendations for user needs. We present example recommendation results ofVirtual Sleep Regulatoron the basis of the dataset from a real world QS application.

The virtual doctor: An interactive clinical-decision-support system based on deep learning for non-invasive prediction of diabetes

Artificial intelligence (AI) will pave the way to a new era in medicine. However, currently available AI systems do not interact with a patient, e.g., for anamnesis, and thus are only used by the physicians for predictions in diagnosis or prognosis. However, these systems are widely used, e.g., in diabetes or cancer prediction. In the current study, we developed an AI that is able to interact with a patient (virtual doctor) by using a speech recognition and speech synthesis system and thus can autonomously interact with the patient, which is particularly important for, e.g., rural areas, where the availability of primary medical care is strongly limited by low population densities. As a proof-of-concept, the system is able to predict type 2 diabetes mellitus (T2DM) based on non-invasive sensors and deep neural networks. Moreover, the system provides an easy-to-interpret probability estimation for T2DM for a given patient. Besides the development of the AI, we further analyzed the acceptance of young people for AI in healthcare to estimate the impact of such a system in the future.

A Clinical Decision Support Framework for Heterogeneous Data Sources

To keep pace with the developments in medical informatics, health medical data is being collected continually. But, owing to the diversity of its categories and sources, medical data has become so complicated in many hospitals that it now needs a clinical decision support (CDS) system for its management. To effectively utilize the accumulating health data, we propose a CDS framework that can integrate heterogeneous health data from different sources such as laboratory test results, basic information of patients, and health records into a consolidated representation of features of all patients. Using the electronic health medical data so created, multilabel classification was employed to recommend a list of diseases and thus assist physicians in diagnosing or treating their patients' health issues more efficiently. Once the physician diagnoses the disease of a patient, the next step is to consider the likely complications of that disease, which can lead to more diseases. Previous studies reveal that correlations do exist among some diseases. Considering these correlations, a k-nearest neighbors algorithm is improved for multilabel learning by using correlations among labels (CML-kNN). The CML- kNN algorithm first exploits the dependence between every two labels to update the origin label matrix and then performs multilabel learning to estimate the probabilities of labels by using the integrated features. Finally, it recommends the top N diseases to the physicians. Experimental results on real health medical data establish the effectiveness and practicability of the proposed CDS framework.

Tailoring motivational health messages for smoking cessation using an mHealth recommender system integrated with an electronic health record: a study protocol

BACKGROUND

Smoking is one of the most avoidable health risk factors, and yet the quitting success rates are low. The usage of tailored health messages to support quitting has been proved to increase quitting success rates. Technology can provide convenient means to deliver tailored health messages. Health recommender systems are information-filtering algorithms that can choose the most relevant health-related items-for instance, motivational messages aimed at smoking cessation-for each user based on his or her profile. The goals of this study are to analyze the perceived quality of an mHealth recommender system aimed at smoking cessation, and to assess the level of engagement with the messages delivered to users via this medium.

METHODS

Patients participating in a smoking cessation program will be provided with a mobile app to receive tailored motivational health messages selected by a health recommender system, based on their profile retrieved from an electronic health record as the initial knowledge source. Patients' feedback on the messages and their interactions with the app will be analyzed and evaluated following an observational prospective methodology to a) assess the perceived quality of the mobile-based health recommender system and the messages, using the precision and time-to-read metrics and an 18-item questionnaire delivered to all patients who complete the program, and b) measure patient engagement with the mobile-based health recommender system using aggregated data analytic metrics like session frequency and, to determine the individual-level engagement, the rate of read messages for each user. This paper details the implementation and evaluation protocol that will be followed.

DISCUSSION

This study will explore whether a health recommender system algorithm integrated with an electronic health record can predict which tailored motivational health messages patients would prefer and consider to be of a good quality, encouraging them to engage with the system. The outcomes of this study will help future researchers design better tailored motivational message-sending recommender systems for smoking cessation to increase patient engagement, reduce attrition, and, as a result, increase the rates of smoking cessation.

TRIAL REGISTRATION

The trial was registered at clinicaltrials.org under the ClinicalTrials.gov identifier NCT03206619 on July 2nd 2017. Retrospectively registered.

A systematic review on the use of best practices for publishing linked data

Purpose

Data providers have been increasingly publishing content as linked data (LD) on the Web. This process includes guidelines (i.e. good practices) to publish, share, and connect data on the Web. Several people in different areas, for instance, sciences, medicine, governments and so on, use these practices to publish data. The LD community has been proposing many practices to aid the publication of data on the Web. However, discovering these practices is a costly and time-consuming task, considering the practices that are produced by the literature. Moreover, the community still lacks a comprehensive understanding of how these practices are used for publishing LD. Thus, the purpose of this paper is to investigate and better understand how best practices support the publication of LD as well as identifying to what extent they have been applied to this field.

Design/methodology/approach

The authors conducted a systematic literature review to identify the primary studies that propose best practices to address the publication of LD, following a predefined review protocol. The authors then identified the motivations for recommending best practices for publishing LD and looked for evidence of the benefits of using such practices. The authors also examined the data formats and areas addressed by the studies as well as the institutions that have been publishing LD.

Findings

In summary, the main findings of this work are: there is empirical evidence of the benefits of using best practices for publishing LD, especially for defining standard practices, integrability and uniformity of LD; most of the studies used RDF as data format; there are many areas interested in dissemination data in a connected way; and there is a great variety of institutions that have published data on the Web.

Originality/value

The results presented in this systematic review can be very useful to the semantic web and LD community, since it gathers pieces of evidence from the primary studies included in the review, forming a body of knowledge regarding the use best practices for publishing LD pointing out interesting opportunities for future research.

Technical Challenges in the Clinical Application of Radiomics

Radiomics is a quantitative approach to medical image analysis targeted at deciphering the morphologic and functional features of a lesion. Radiomic methods can be applied across various malignant conditions to identify tumor phenotype characteristics in the images that correlate with their likelihood of survival, as well as their association with the underlying biology. Identifying this set of characteristic features, called tumor signature, holds tremendous value in predicting the behavior and progression of cancer, which in turn has the potential to predict its response to various therapeutic options. We discuss the technical challenges encountered in the application of radiomics, in terms of methodology, workflow integration, and user experience, that need to be addressed to harness its true potential.

HealthRecSys: A semantic content-based recommender system to complement health videos

BACKGROUND

The Internet, and its popularity, continues to grow at an unprecedented pace. Watching videos online is very popular; it is estimated that 500 h of video are uploaded onto YouTube, a video-sharing service, every minute and that, by 2019, video formats will comprise more than 80% of Internet traffic. Health-related videos are very popular on YouTube, but their quality is always a matter of concern. One approach to enhancing the quality of online videos is to provide additional educational health content, such as websites, to support health consumers. This study investigates the feasibility of building a content-based recommender system that links health consumers to reputable health educational websites from MedlinePlus for a given health video from YouTube.

METHODS

The dataset for this study includes a collection of health-related videos and their available metadata. Semantic technologies (such as SNOMED-CT and Bio-ontology) were used to recommend health websites from MedlinePlus. A total of 26 healths professionals participated in evaluating 253 recommended links for a total of 53 videos about general health, hypertension, or diabetes. The relevance of the recommended health websites from MedlinePlus to the videos was measured using information retrieval metrics such as the normalized discounted cumulative gain and precision at K.

RESULTS

The majority of websites recommended by our system for health videos were relevant, based on ratings by health professionals. The normalized discounted cumulative gain was between 46% and 90% for the different topics.

CONCLUSIONS

Our study demonstrates the feasibility of using a semantic content-based recommender system to enrich YouTube health videos. Evaluation with end-users, in addition to healthcare professionals, will be required to identify the acceptance of these recommendations in a nonsimulated information-seeking context.