Collaborative Ontology Engineering Methodologies for the Development of Decision Support Systems: Case Studies in the Healthcare Domain

Towards a knowledge-based decision support system to foster the return to work of wheelchair users

Accidents at work may force workers to face abrupt changes in their daily life: one of the most impactful accident cases consists of the worker remaining in a wheelchair. Return To Work (RTW) of wheelchair users in their working age is still challenging, encompassing the expertise of clinical and rehabilitation personnel and social workers to match the workers' residual capabilities with job requirements. This work describes a novel and prototypical knowledge-based Decision Support System (DSS) that matches workers' residual capabilities with job requirements, thus helping vocational therapists and clinical personnel in the RTW decision-making process for WUs. The DSS leverages expert knowledge in the form of ontologies to represent the International Classification of Functioning, Disability, and Health (ICF) and the Occupational Information Network (O*NET). These taxonomies enable both workers' health conditions and job requirements formalization, which are processed to assess the suitability of a job depending on a worker's condition. Consequently, the DSS suggests a list of jobs a wheelchair user can still perform, exploiting his/her residual abilities at their best. The manuscript describes the theoretical approach and technological foundations of such DSS, illustrating its development, its output metric, and application. The developed solution was tested with real wheelchair users' health conditions provided by the Italian National Institute for Insurance against Accidents at Work. The feasibility of an approach based on objective data was thus demonstrated, providing a novel point of view in the critical process of decision-making during RTW.

A knowledge-based decision support system to support family doctors in personalizing type-2 diabetes mellitus medical nutrition therapy

BACKGROUND

Type-2 Diabetes Mellitus (T2D) is a growing concern worldwide, and family doctors are called to help diabetic patients manage this chronic disease, also with Medical Nutrition Therapy (MNT). However, MNT for Diabetes is usually standardized, while it would be much more effective if tailored to the patient. There is a gap in patient-tailored MNT which, if addressed, could support family doctors in delivering effective recommendations. In this context, decision support systems (DSSs) are valuable tools for physicians to support MNT for T2D patients - as long as DSSs are transparent to humans in their decision-making process. Indeed, the lack of transparency in data-driven DSS might hinder their adoption in clinical practice, thus leaving family physicians to adopt general nutrition guidelines provided by the national healthcare systems.

METHOD

This work presents a prototypical ontology-based clinical Decision Support System (OnT2D- DSS) aimed at assisting general practice doctors in managing T2D patients, specifically in creating a tailored dietary plan, leveraging clinical expert knowledge. OnT2D-DSS exploits clinical expert knowledge formalized as a domain ontology to identify a patient's phenotype and potential comorbidities, providing personalized MNT recommendations for macro- and micro-nutrient intake. The system can be accessed via a prototypical interface.

RESULTS

Two preliminary experiments are conducted to assess both the quality and correctness of the inferences provided by the system and the usability and acceptance of the OnT2D-DSS (conducted with nutrition experts and family doctors, respectively).

CONCLUSIONS

Overall, the system is deemed accurate by the nutrition experts and valuable by the family doctors, with minor suggestions for future improvements collected during the experiments.

An Ontology-Based Decision Support System for Tailored Clinical Nutrition Recommendations for Patients With Chronic Obstructive Pulmonary Disease: Development and Acceptability Study

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a chronic condition among the main causes of morbidity and mortality worldwide, representing a burden on health care systems. Scientific literature highlights that nutrition is pivotal in respiratory inflammatory processes connected to COPD, including exacerbations. Patients with COPD have an increased risk of developing nutrition-related comorbidities, such as diabetes, cardiovascular diseases, and malnutrition. Moreover, these patients often manifest sarcopenia and cachexia. Therefore, an adequate nutritional assessment and therapy are essential to help individuals with COPD in managing the progress of the disease. However, the role of nutrition in pulmonary rehabilitation (PR) programs is often underestimated due to a lack of resources and dedicated services, mostly because pneumologists may lack the specialized training for such a discipline.

OBJECTIVE

This work proposes a novel knowledge-based decision support system to support pneumologists in considering nutritional aspects in PR. The system provides clinicians with patient-tailored dietary recommendations leveraging expert knowledge.

METHODS

The expert knowledge-acquired from experts and clinical literature-was formalized in domain ontologies and rules, which were developed leveraging the support of Italian clinicians with expertise in the rehabilitation of patients with COPD. Thus, by following an agile ontology engineering methodology, the relevant formal ontologies were developed to act as a backbone for an application targeted at pneumologists. The recommendations provided by the decision support system were validated by a group of nutrition experts, whereas the acceptability of such an application in the context of PR was evaluated by pneumologists.

RESULTS

A total of 7 dieticians (mean age 46.60, SD 13.35 years) were interviewed to assess their level of agreement with the decision support system's recommendations by evaluating 5 patients' health conditions. The preliminary results indicate that the system performed more than adequately (with an overall average score of 4.23, SD 0.52 out of 5 points), providing meaningful and safe recommendations in compliance with clinical practice. With regard to the acceptability of the system by lung specialists (mean age 44.71, SD 11.94 years), the usefulness and relevance of the proposed solution were extremely positive-the scores on each of the perceived usefulness subscales of the technology acceptance model 3 were 4.86 (SD 0.38) out of 5 points, whereas the score on the intention to use subscale was 4.14 (SD 0.38) out of 5 points.

CONCLUSIONS

Although designed for the Italian clinical context, the proposed system can be adapted for any other national clinical context by modifying the domain ontologies, thus providing a multidisciplinary approach to the management of patients with COPD.

Developing a Novel Ontology for Cybersecurity in Internet of Medical Things-Enabled Remote Patient Monitoring

IoT has seen remarkable growth, particularly in healthcare, leading to the rise of IoMT. IoMT integrates medical devices for real-time data analysis and transmission but faces challenges in data security and interoperability. This research identifies a significant gap in the existing literature regarding a comprehensive ontology for vulnerabilities in medical IoT devices. This paper proposes a fundamental domain ontology named MIoT (Medical Internet of Things) ontology, focusing on cybersecurity in IoMT (Internet of Medical Things), particularly in remote patient monitoring settings. This research will refer to similar-looking acronyms, IoMT and MIoT ontology. It is important to distinguish between the two. IoMT is a collection of various medical devices and their applications within the research domain. On the other hand, MIoT ontology refers to the proposed ontology that defines various concepts, roles, and individuals. MIoT ontology utilizes the knowledge engineering methodology outlined in Ontology Development 101, along with the structured life cycle, and establishes semantic interoperability among medical devices to secure IoMT assets from vulnerabilities and cyberattacks. By defining key concepts and relationships, it becomes easier to understand and analyze the complex network of information within the IoMT. The MIoT ontology captures essential key terms and security-related entities for future extensions. A conceptual model is derived from the MIoT ontology and validated through a case study. Furthermore, this paper outlines a roadmap for future research, highlighting potential impacts on security automation in healthcare applications.

Application of a text mining method in navigation and communication for enhancing maritime safety

This paper introduces a model for the translation of natural language into ontology and vice versa in an autonomous navigation system of a sea-going vessel. The system comprehensively executes communication tasks at sea. The authors use machine learning methods in the field of text mining and basic and additional properties of ontologies. The newly developed ontology is applicable in shipping. The key elements of the prototype are the sequence of communication commands given from the ship's bridge, decomposition, extraction of the communication sequence and the rule base. The presented model has been implemented and verified in selected scenarios of collision situations at sea. The test results confirm that the assumptions, the designed system architecture and the algorithms in the prototype are correct.

Ranking the ontology development methodologies using the weighted decision matrix

Purpose

The current work provides a framework for the ranking of ontology development methodologies (ODMs).

Design/methodology/approach

The framework is a step-by-step approach reinforced by an array of ranking features and a quantitative tool, weighted decision matrix. An extensive literature investigation revealed a set of aspects that regulate ODMs. The aspects and existing state-of-the-art estimates facilitated in extracting the features. To determine weight to each of the features, an online survey was implemented to secure evidence from the Semantic Web community. To demonstrate the framework, the authors perform a pilot study, where a collection of domain ODMs, reported in 2000–2019, is used.

Findings

State-of-the-art research revealed that ODMs have been accumulated, surveyed and assessed to prescribe the best probable ODM for ontology development. But none of the prevailing studies provide a ranking mechanism for ODMs. The recommended framework overcomes this limitation and gives a systematic and uniform way of ranking the ODMs. The pilot study yielded NeOn as the top-ranked ODM in the recent two decades.

Originality/value

There is no work in the literature that has investigated ranking the ODMs. Hence, this is a first of its kind work in the area of ODM research. The framework supports identifying the topmost ODMs from the literature possessing a substantial amount of features for ontology development. It also enables the selection of the best possible ODM for the ontology development.

Uncertainty-Driven Ontology for Decision Support System in Air Transport

Recent electronics advances for air transport have increased aircraft density, volume, and frequency in the airspace. These advances come with control requirements for precise navigation, coordinated Air Traffic Management (ATM) or Unmanned aircraft system Traffic Management (UTM), and proactive security. The tight tolerances of aircraft control necessitate management of spatial uncertainty, timeliness precision, and confidence assessment, which have, respectively, variance, reliability, and veracity situation awareness and assessment metrics. Meeting such airspace requirements involves the ability to evaluate how those metrics impact ATM/UTM operations, making the complex interrelationships between them a key aspect for coping with the fast worldwide growth of air transport. To support such growth, ontologies have been proposed as a promising technology for making such interrelationships explicit, while facilitating communication between avionics devices. This paper investigates the use of ontologies in support of electronic ATM/UTM operations, highlighting the use of Uncertainty Representation and the Reasoning Evaluation Framework (URREF) in realizing the ability for Air Traffic Controllers (ATCs) to semantically communicate with aircraft operators concerning physical airspace coordination. Using Avionics Analytics Ontology (AAO) endowed with the URREF, application examples based on two airspace situations are presented. Example results for northeast coast of Brazil atmospheric volcanic ash as well as for the Eyjafjallajokull volcano eruption show a 65–80% success in providing warnings to ATCs for airspace control. The paper demonstrates that an ontology-based UTM enhances the capability and accuracy of an ATM to suggest rerouting in the presence of remarkably deteriorated weather conditions.

Interfaces for Searching and Triaging Large Document Sets: An Ontology-Supported Visual Analytics Approach

We investigate the design of ontology-supported, progressively disclosed visual analytics interfaces for searching and triaging large document sets. The goal is to distill a set of criteria that can help guide the design of such systems. We begin with a background of information search, triage, machine learning, and ontologies. We review research on the multi-stage information-seeking process to distill the criteria. To demonstrate their utility, we apply the criteria to the design of a prototype visual analytics interface: VisualQUEST (Visual interface for QUEry, Search, and Triage). VisualQUEST allows users to plug-and-play document sets and expert-defined ontology files within a domain-independent environment for multi-stage information search and triage tasks. We describe VisualQUEST through a functional workflow and culminate with a discussion of ongoing formative evaluations, limitations, future work, and summary.

Ontology-Based Reasoning for Educational Assistance in Noncommunicable Chronic Diseases

Noncommunicable chronic diseases (NCDs) affect a large part of the population. With the emergence of COVID-19, its most severe cases impact people with NCDs, increasing the mortality rate. For this reason, it is necessary to develop personalized solutions to support healthcare considering the specific characteristics of individuals. This paper proposes an ontology to represent the knowledge of educational assistance in NCDs. The purpose of ontology is to support educational practices and systems oriented towards preventing and monitoring these diseases. The ontology is implemented under Protégé 5.5.0 in Ontology Web Language (OWL) format, and defined competency questions, SWRL rules, and SPARQL queries. The current version of ontology includes 138 classes, 31 relations, 6 semantic rules, and 575 axioms. The ontology serves as a NCDs knowledge base and supports automatic reasoning. Evaluations performed through a demo dataset demonstrated the effectiveness of the ontology. SWRL rules were used to define accurate axioms, improving the correct classification and inference of six instantiated individuals. As a scientific contribution, this study presents the first ontology for educational assistance in NCDs.

Delta: A Modular Ontology Evaluation System

Ontologies are widely used nowadays. However, the plethora of ontologies currently available online, makes it really difficult to identify which ontologies are appropriate for a given task and to decide on their quality characteristics. This is further complicated by the fact that multiple quality criteria have been proposed for ontologies, making it even more difficult to decide which ontology to adopt. In this context, in this paper we present Delta, a modular online tool for analyzing and evaluating ontologies. The interested user can upload an ontology to the tool, which then automatically analyzes it and graphically visualizes numerous statistics, metrics, and pitfalls. Those visuals presented include a diverse set of quality dimensions, further guiding users to understand the benefits and the drawbacks of each individual ontology and how to properly develop and extend it.

An Ontology-Driven Personalized Faceted Search for Exploring Knowledge Bases of Capsicum

Capsicum is a genus of flowering plants in the Solanaceae family in which the members are well known to have a high economic value. The Capsicum fruits, which are popularly known as peppers or chili, have been widely used by people worldwide. It serves as a spice and raw material for many products such as sauce, food coloring, and medicine. For many years, scientists have studied this plant to optimize its production. A tremendous amount of knowledge has been obtained and shared, as reflected in multiple knowledge-based systems, databases, or information systems. An approach to knowledge-sharing is through the adoption of a common ontology to eliminate knowledge understanding discrepancy. Unfortunately, most of the knowledge-sharing solutions are intended for scientists who are familiar with the subject. On the other hand, there are groups of potential users that could benefit from such systems but have minimal knowledge of the subject. For these non-expert users, finding relevant information from a less familiar knowledge base would be daunting. More than that, users have various degrees of understanding of the available content in the knowledge base. This understanding discrepancy raises a personalization problem. In this paper, we introduce a solution to overcome this challenge. First, we developed an ontology to facilitate knowledge-sharing about Capsicum to non-expert users. Second, we developed a personalized faceted search algorithm that provides multiple structured ways to explore the knowledge base. The algorithm addresses the personalization problem by identifying the degree of understanding about the subject from each user. In this way, non-expert users could explore a knowledge base of Capsicum efficiently. Our solution characterized users into four groups. As a result, our faceted search algorithm defines four types of matching mechanisms, including three ranking mechanisms as the core of our solution. In order to evaluate the proposed method, we measured the predictability degree of produced list of facets. Our findings indicated that the proposed matching mechanisms could tolerate various query types, and a high degree of predictability can be achieved by combining multiple ranking mechanisms. Furthermore, it demonstrates that our approach has a high potential contribution to biodiversity science in general, where many knowledge-based systems have been developed with limited access to users outside of the domain.

A Framework for Evaluating Agricultural Ontologies

An ontology is a formal representation of domain knowledge, which can be interpreted by machines. In recent years, ontologies have become a major tool for domain knowledge representation and a core component of many knowledge management systems, decision-support systems and other intelligent systems, inter alia, in the context of agriculture. A review of the existing literature on agricultural ontologies, however, reveals that most of the studies, which propose agricultural ontologies, are lacking an explicit evaluation procedure. This is undesired because without well-structured evaluation processes, it is difficult to consider the value of ontologies to research and practice. Moreover, it is difficult to rely on such ontologies and share them on the Semantic Web or between semantic-aware applications. With the growing number of ontology-based agricultural systems and the increasing popularity of the Semantic Web, it becomes essential that such evaluation methods are applied during the ontology development process. Our work contributes to the literature on agricultural ontologies by presenting a framework that guides the selection of suitable evaluation methods, which seems to be missing from most existing studies on agricultural ontologies. The framework supports the matching of appropriate evaluation methods for a given ontology based on the ontology’s purpose.