Biosurveillance 2.0 Collaboration and Web 2.0/3.0 Semantic Technologies for Better Early Disease Warning and Effective Response Taha Kass-Hout Nicolás di Tada Invited by Dr. Barbara Massoudi, PhD, MPH Lecture at Emory University Rollins School of Public Health Public Health Informatics, INFO 503 Atlanta, GA, USA
Invited lecture at Emory University Rollins School of Public Health. We presented our InSTEDD global early warning and response social platform; Evolve (http://instedd.org/evolve) with live demonstration.
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Biosurveillance 2.0 Collaboration and Web 2.0/3.0 Semantic
Technologies for Better Early Disease Warning and Effective Response
Taha Kass-HoutNicolás di Tada
Invited by Dr. Barbara Massoudi, PhD, MPH
Lecture at Emory University Rollins School of Public Health
Public Health Informatics, INFO 503
Atlanta, GA, USA
Background
DAY
CA
SE
S
Opportunity for control
Background
Late Detection and Response
DAY
CA
SE
S
Opportunity for control
Background
Early Detection and Response
Public Health Measures
• Representativeness
• Completeness
• Predictive Value
• Timeliness
Background
Public Health Measures
1000 Malaria infections (100%)
50 Malaria notifications (5%)
Get as close to the bottom of the pyramid
as possible
Urge frequent reporting: Weekly daily immediately
Specificity / Reliability
Sensitivity / Timeliness • Main attributes
o Representativenesso Completenesso Predictive value positive
Background
Analyze and interpret
Signal as early
as possible
Automated analysis/thresholds
Time
• Main attributeso Timeliness
Public Health MeasuresHealth care hotline
Background
Public Health – Two Perspectives
• Case management – Individual cases of notifiable diseases– Relationship networks (contact
tracing)
• Population surveillance– Larger risk patterns
Background
Case Management
• Questions and problems:– Is a case due to recent transmission?– If so, does the case share any feature with
other recent cases?
• Current methods:– Investigations and interviews– Meeting with other investigators
Background
Population Surveillance
• Questions and problems:– Are more cases happening than expected?– Does an excess suggest ongoing transmission
in a specific region?
• Current methods:– Semi-automated routine temporal and
space-time statistical analysis
Background
Why location matters:Case Management
• If you are studying a case of a certain disease that was just declared
• It is harder to picture the situation by looking at something like this...
Background
Background
Why location matters:Case Management
Why location matters:Case Management
• Than by looking at this..
Background
Why location matters:Case Management
Background
Why location matters:Population Surveillance
• If you are studying the spatial distribution of a set of disease clusters, this next slide seems more difficult…
Background
Why location matters:Population Surveillance
Background
Why location matters:Population Surveillance
• Than this...
Background
Why location matters:Population Surveillance
Background
The Problem Space
• Current systems design, analysis and evaluation has been geared towards specific data sources and detection algorithms – not humans
• We have systems in place for those threats we have been faced with before
The Problem
Traditional DISEASE SURVEILLANCE
• In the past two decades focus was on – automatically detecting anomalous patterns in
data (often a single stream)
• Modern methods– rely on human input and judgment – incorporate temporal, spatial, and multivariate
information
The Problem
9/20, 15213, cough/cold, …9/21, 15207, antifever, …9/22, 15213, CC = cough, ...1,000,000 more records…
Huge mass of data Detection algorithm “What are we supposed to do with
this?”
Too many alerts
Traditional DISEASE SURVEILLANCE
The Problem
Our Approach
• Human-based
• Collaborative and cross-disciplinary
• Web 2.0/3.0 platform
Our Approach
Information Sources
• Event-based - ad-hoc unstructured reports issued by formal or informal sources
• Indicator-based - (number of cases, rates, proportion of strains…)
• Given a set of stimuli, train a system to produce a given output…
Our Solution
Hidden LayerHidden Layer
Output LayerOutput Layer
Input LayerInput Layer
Neural Network: Structure
[…]
[…]
{I0,I1,……In}
{O0,O1,……On}
Weight
Weight
).(0 in
I
i in wIH
Our Solution
Neural Network:Application
Event?
Our Solution
(5) Genetic Algorithm:Basic
• Define the model that you want to optimize
• Create the fitness function
• Evolve the gene pool testing against the fitness function.
• Select the best individual
Our Solution
Genetic Algorithm:Model
• Model the transmission process using a set of parameters (e.g., an infectious disease):– Onset time between an infection and illness– Latency period– Incubation period– Symptomatic period– Infectious period
Filter feature which automatically filters for related items, updates the map and associated tagsFilter feature which automatically filters for related items, updates the map and associated tags
Tracking the recent Avian Influenza Outbreak in Egypt (reports started to appear late January 2009). Notice the pattern of reported incidents along the Nile river.
Tracking the recent Avian Influenza Outbreak in Egypt (reports started to appear late January 2009). Notice the pattern of reported incidents along the Nile river.
– The Future of Statistical Computing in Wilkinson (2008)– Complex Event Processing Over Uncertain Data in Wasserkrug (2008)– Outbreak detection through automated surveillance A review of the
determinants of detection in Buckeridge (2007) – Approaches to the evaluation of outbreak detection methods in
Watkins (2006)– Algorithms for rapid outbreak detection a research synthesis
Buckeridge (2004)– Data mining in bioinformatics using Weka in Frank (2004)– Aho-Corasick Algorithm in Kilpeläinen
• Automating Laboratory Reporting– Automatic Electronic Laboratory-Based Reporting in Panackal (2002)– Benefits and Barriers to Electronic Laboratory Results Reporting for Notifiable
Diseases in Nguyen (2007)
REFERENCES• Using EMR Data for Disease Surveillance
– Using Electronic Medical Records to Enhance Detection and Reporting of Vaccine Adverse Events in Hinrichsen (2007)
– Electronic Medical Record Support for PH in Klompas (2007)– A knowledgebase to support notifiable disease surveillance in Doyle (2005)– Automated Detection of Tuberculosis Using Electronic Medical Record Data in
Calderwood (2007)• Misc Readings
– Breakthrough in modeling emerging disease hotspots in Jones (2008)– Use of data mining techniques to investigate disease risk classification as a
proxy for compromised biosecurity of cattle herds in Wales in Ortiz-Pelaez (2008)
RELATED PROJECTS• InSTEDD Evolve: (http://instedd.org/evolve)
– Collaborative Analytics and Environment for Linking Early Health-Related Event Detection to an Effective Response (http://taha.instedd.org/2008/09/collaborative-analytics-and-environment.html )
• ALPACA "ALPACA Light Parsing And Classifying Application (ALPACA) is a classifying tool designed for use in community-oriented software as well as in Academia. The application consists of two parts: a parsing tool for transforming raw documents into readable data, and a classifying tool for categorizing documents into user-provided classes. The application provides a user-friendly interface and a Plug-in functionality to provide a simple way to add more parsers/classifiers to the application." http://2008.hfoss.org/ALPACA
• Weka An open source "...collection of machine learning algorithms for data mining tasks. The algorithms can either be applied directly to a dataset or called from your own Java code. Weka contains tools for data pre-processing, classification, regression, clustering, association rules, and visualization. It is also well-suited for developing new machine learning schemes." http://www.cs.waikato.ac.nz/~ml/weka/
RELATED PROJECTS• The R Project for statistical computing: http://www.r-project.org
– Surveillance Project: An Open Source R-package disease surveillance framework for "...the development and the evaluation of outbreak detection algorithms in univariate and multivariate routine collected public health surveillance data." http://surveillance.r-forge.r-project.org
• The R package surveillance in Höhle (multiple articles)
• Google's Research Publications: MapReduce Simplified Data Processing on Large Clusters (http://labs.google.com/papers/mapreduce.html)– Hadoop: a software platform that lets one easily write and run applications
that process vast amounts of data (http://hadoop.apache.org/core)
OPEN SOURCE SOFTWAREReferences and Related-Efforts
• Open Source and Public Health References– http://www.ibiblio.org/pjones/wiki/index.php/
Open_Source_Software_for_Public_Health – http://en.wikipedia.org/wiki/List_of_open_source_healthcare_software – http://www.epha.org/a/320 – Open Source Development for Public Health: A Primer with Examples of Existing
Enterprise Ready Open Source Applications in Turner (2006)– A Quick Survey of Open Source Software for Public Health Organizations in Mirabito
and Kass-Hout (2007)
ARCHITECTURAL MATTERSReferences and Related-Efforts
REFERENCES• Service Oriented Architecture (or SOA)
– Proposal for Fulfilling Strategic Objectives of the U.S. Roadmap for National Action on Decision Support through a Service—oriented Architecture Leveraging HL7 Services in Kawamoto (2007)
– Service-oriented Architecture in Medical Software: Promises and Perils in Nadkarni (2007)
– Wiki sources:• SOA: http://en.wikipedia.org/wiki/Service_Orientated_Architecture • Semantic service oriented architecture: