Chronic Diseases are the major cause of mortality around the world, accounting for 7 out of 10 deaths each year in the United States. Because of its adverse effect on the quality of life, it has become a major problem globally. Health care costs involved in managing these diseases are also very high. In this thesis, we will focus on two major chronic diseases Asthma and Diabetes, which are among the leading causes of mortality around the globe. It involves design and development of a predictive analytics based decision support system which uses five supervised machine learning algorithm to predict the occurrence of Asthma and Diabetes. This system helps in controlling the disease well in advance by selecting its best indicators and providing necessary feedback. / Includes bibliography. / Thesis (M.S.)--Florida Atlantic University, 2015. / FAU Electronic Theses and Dissertations Collection

A Atenção Primária à Saúde é reconhecida como base para um sistema de informação em saúde (SIS) eficiente, razão pela qual justifica-se a importância de reestruturação a fim de atender os novos conceitos tecnológicos de integração das informações e interoperabilidade entre os SIS. Tal relevância resultou na Estratégia e-SUS AB composta: pelo Sistema de Informação em Saúde para Atenção Básica (SISAB); e pelo e-SUS AB. Dessa maneira, passou a ser o SIS vigente para fins de financiamento e de adesão aos programas de estratégias da Política Nacional de Atenção Básica. A pluralidade dos cenários de informatização e conectividade resultou na disponibilização de dois sistemas de software - Coleta de Dados Simplificada (CDS) e Prontuário Eletrônico do Cidadão -, responsáveis por alimentar o SISAB. Relatos de usuários do e-SUS AB identificaram falhas na capacitação e dificuldades para sanar dúvidas, reforçando a importância de uma educação permanente para qualificar as práticas em saúde, além da imprescindibilidade de olhar para as possíveis lacunas nos sistemas próprios. Este estudo teve como objetivos: elaborar um protótipo com oportunidades de melhorias para o módulo CDS do e-SUS AB, integrado no sistema proprietário utilizado no local da pesquisa; e desenvolver e avaliar um manual web, elaborado a partir de um diagnóstico de dúvidas e dificuldades dos agentes comunitários de saúde (ACS). Trata-se de uma pesquisa aplicada, com abordagem qualitativa, na modalidade pesquisa-ação. A população amostral foi constituída pelos ACS alocados em seis Núcleos da Saúde da Família do distrito Oeste do município de Ribeirão Preto e por especialistas de informática, que aceitaram participar da pesquisa por meio da assinatura do Termo de Consentimento Livre e Esclarecido. A coleta de dados ocorreu mediante observação das atividades do ACS utilizando o sistema e-SUS AB, módulo CDS, além de entrevistas não estruturadas. Para o desenvolvimento do protótipo foi utilizado o programa AXURE RP Pro 7.0, que gera protótipos interativos e para o desenvolvimento do manual web foi utilizado linguagem de marcação interpretada por navegadores. Tanto o protótipo quanto o manual web e-SUS foram avaliados por meio de aplicação de questionário. Os resultados evidenciam a importância de conhecer os aspectos relacionados ao modo de trabalho, ou de comportamento, que possam influenciar na qualidade final dos dados inseridos nos SIS. Da mesma maneira, visam a obter insumos para a definição dos requisitos e metas de usabilidade, a fim de atender os diferentes papéis-de-usuário identificados e, ainda, reforça a relevância de olhar para os sistemas próprios, adquiridos no mercado privado ou desenvolvidos no município. A aproximação entre o pesquisador e as pessoas implicadas na situação investigada proporcionou detectar lacunas entre os componentes indispensáveis para efetivar as ações que objetivam a consolidação da informatização em saúde e, sobretudo, delinear potenciais soluções para os problemas apontados / Primary Health Care is recognized as the basis for an efficient health information system, highlighting the importance of restructuring in order to meet the new technological concepts of information integration and interoperability among SIS. This action resulted in the e-SUS AB Strategy composed by the Health Information System for Basic Care (SISAB) and e-SUS AB and became the current health information system for funding and adherence to National Policy strategies programs of Basic Attention. The plurality of computerization and connectivity scenarios resulted in the availability of two software systems: Simplified Data Collection (CDS) and Electronic Health Record, responsible for feeding SISAB. Reports from users of e-SUS AB identified deficiencies in training and difficulties to resolve doubts, reinforcing the importance of a permanent education to qualify health practices beyond the importance of looking at possible gaps in the systems themselves. The purpose of this study was to develop a prototype with improvement opportunities for the CDS module of e-SUS AB, integrated in the proprietary system used at the research site, and to develop and evaluate a web manual, based on a diagnosis of doubts and difficulties of community health agents (ACS). This is an applied research, with a qualitative approach, in the research-action modality. The sample population consisted of the ACS assigned to six Family Health Centers of the western district of the city of Ribeirão Preto and by computer specialists, who agreed to participate in the study through the signing of the Informed Consent Term. Data collection was based on the observation of ACS activities using the e-SUS AB system, CDS module, in addition to unstructured interviews. For the prototype development, the AXURE RP Pro 7.0 program was used, which generates interactive prototypes and for the web manual development, it was used marking language interpreted by browsers. Both the prototype and the e-SUS web manual were evaluated through a questionnaire application. The results show the importance of knowing the aspects related to the way of work, or behavior, that can influence the final quality of the data inserted in the health information system as well as to obtain inputs for the definition of usability requirements and goals, in order to meet the different Identified user roles. Also reinforces the importance of looking at the own systems, acquired in the private market or developed in the municipality. The approximation between the researcher and the people involved in the investigated situation revealed gaps between the indispensable components to carry out the actions that aim at the consolidation of the informatization in health and the delineation of potential solutions to the mentioned problems

Microarray expression data which contains the expression levels of a large number of simultaneously observed genes have been used in many scientific research and clinical studies. Due to its high dimensionalities, selecting a small number of genes has shown to be beneficial for many tasks such as building prediction models from the microarray expression data or gene regulatory network discovery. Traditional gene selection methods, however, fail to take the class distribution into the selection process. In biomedical science, it is very common to have microarray expression data which is severely biased with one class of examples (e.g., diseased samples) significantly less than other classes (e.g., normal samples). These sample sets with biased distributions require special attention from researchers for identification of genes responsible for a particular disease. In this thesis, we propose three filtering techniques, Higher Weight ReliefF, ReliefF with Differential Minority Repeat and ReliefF with Balanced Minority Repeat to identify genes responsible for fatal diseases from biased microarray expression data. Our solutions are evaluated on five well-known microarray datasets, Colon, Central Nervous System, DLBCL Tumor, Lymphoma and ECML Pancreas. Experimental comparisons with the traditional ReliefF filtering method demonstrate the effectiveness of the proposed methods in selecting informative genes from microarray expression data with biased sample distributions. / by Abu Hena Mustafa Kamal. / Thesis (M.S.C.S.)--Florida Atlantic University, 2009. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2009. Mode of access: World Wide Web.

Use of the Internet can increase patients' understanding about their medical conditions and offers opportunities to strengthen the patient-physician relationship, increase patient satisfaction, and improve health outcomes. However, physicians vary widely in the extent to which they accept patient online medical information seeking and make it part of the patient-physician relationship. This paper explores factors impacting the extent to which physicians advocate (encourage, speak in favor, or are supportive of) patient internet use. Specifically, using social cognitive theory as a theoretical base, this study develops a model of the determinants of physician advocation of patient use of the internet for information about medical conditions and treatments. Survey data collected from a random sample of 179 physicians licensed to practice medicine in Florida is used to test the proposed model. Proxy efficacy for patient internet use, social efficacy for enlisting patient internet use, performance outcomes expectations, and personal outcome expectations are shown to be significant determinants of physician professional advocation of patient internet use. In addition to its direct impact, proxy efficacy is shown to influence intention to advocate patient internet use indirectly thru social efficacy and outcome expectations, demonstrating the key role of this construct in the proxy agency model. Self-efficacy, in contrast, is not found to be a significant factor. Overall, the results support the proposed model of technology use. / by Neil Morton. / Thesis (Ph.D.)--Florida Atlantic University, 2009. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2009. Mode of access: World Wide Web.

The efforts addressed in this thesis refer to applying nonlinear risk predictive techniques based on logistic regression to medical diagnostic test data. This study is motivated and pursued to address the following: 1. To extend logistic regression model of biostatistics to medical informatics 2. Computational preemptive and predictive testing to determine the probability of occurrence (p) of an event by fitting a data set to a (logit function) logistic curve: Finding upper and lower bounds on p based on stochastical considerations 3. Using the model developed on available (clinical) data to illustrate the bounds-limited performance of the prediction. Relevant analytical methods, computational efforts and simulated results are presented. Using the results compiled, the risk evaluation in medical diagnostics is discussed with real-world examples. Conclusions are enumerated and inferences are made with directions for future studies. / by Alice Horn Dupont. / Thesis (M.S.C.S.)--Florida Atlantic University, 2011. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2011. Mode of access: World Wide Web.

Health information exchange (HIE) has the potential to improve care quality through improved information sharing and coordination of care. In Phase 1, a sociotechnical analysis was conducted at one HIV clinic to explore the interrelated factors that affect the consent of persons living with HIV (PLWH) to electronically share their protected health information (PHI) through a HIE. The findings of the sociotechnical analysis revealed that there is not a single solution that can adequately address the complex, interrelated issues that affect PLWH decision to electronically share PHI. Improvement in the consent process was selected as the target of intervention for Phase 2, which focused on designing and pilot testing a prototype HIE eConsent iPad app at the HIV clinic. A one-group post-test design examined if HIV clinic patients preferred the eConsent or the paper consent. Semi-structured interviews were used to assess overall comprehension of HIE after reading both consents. Over half of the participants favored eConsent as compared to paper consent. The proportion of participants who were able to verbalize essential components of HIE were as follows: more than one component – 35%, one component - 20%, and no component – 45%. While racially and ethnically diverse, the sample was well-educated (50% with a college degree); however, the low comprehension levels suggested that educational attainment was insufficient for HIE comprehension. A hybrid approach that integrates discussion with knowledgeable personnel and multimedia usage may be useful to convey complex information and facilitate HIE comprehension.

This dissertation focuses on understanding and supporting individual and collective sensemaking within online health communities (OHCs). This major goal was achieved in three aims. In Aim 1, this dissertation contributes a rich descriptive account of collective sensemaking in OHCs forums by describing how it occurs and develops, what triggers it, what elements constitute collective construction of meaning, and what conversational moves positively contribute to this process. Further, it describes how collective sensemaking in OHCs is impacted by the interplay between informational and socio-emotional needs of OHCs members. Moreover, it examines how design of different social computing platforms influences OHCs members’ ability to meet their informational and socio-emotional needs and engage in collective sensemaking. In Aim 2, this dissertation explores the design space of tools for supporting individual sensemaking through optimized information access. Through the design and evaluation of a prototype DisVis it examines the impact of such tools on OHCs members’ ability to understand information within discussion threads. In the final Aim 3, this dissertation proposes a novel approach for meeting the three main needs identified in Aims 1 and 2: promoting individual sensemaking, while at the same time encouraging collective sensemaking, and facilitating development of social awareness and ties among community members. The design and evaluation of the novel solution for visualizing discussion threads that synergistically addresses these three needs—dSense—provides insights for future research and design of interactive solutions for supporting individual and collective sensemaking within OHCs.

China has attracted increasing amounts of foreign investment since it opened its doors to the world and whilst many researchers have focused on foreign investment in popular areas, little has been written about medical device market. The medical device market is one of the most profitable areas in the global economy. With the development of China's economy, the Chinese medical device market is experiencing significant growth, and has become the second largest market in the world. The research in this thesis extracted foreign direct investment theory and summarized the current situation of the global medical device market and the Chinese medical device market. Analysis of the status of the Chinese medical device market from the perspective of the healthcare industry and its important market drivers, reveals that the medical device market has significant growth potential. The research methods such as: regression analysis; location quotient, which revealed the Chinese medical device market status, provides suggestions for investors who are interested in entering the Chinese market. Investors or companies who want to enter the Chinese market need to understand the regulatory environment, comparison of the medical device regulations with the US and EU regulations provide investors with a clear understanding of the Chinese medical device regulatory regime. The research in this thesis contributes to medical device market investment and regional economy in medical device industry, and make a clear statement of the changing medical device regulations in China, which came into force on 2014. The contribution of this thesis, bridges the research gap between investment theory and medical device market development.

This research provides evidence that standards based Clinical Decision Support (CDS) at the point of care is an essential ingredient of electronic healthcare service delivery. A Service Oriented Architecture (SOA) based solution is explored, that serves as a task management system to coordinate complex distributed and disparate IT systems, processes and resources (human and computer) to provide standards based CDS. This research offers a solution to the challenges in implementing computerised CDS such as integration with heterogeneous legacy systems. Reuse of components and services to reduce costs and save time. The benefits of a sharable CDS service that can be reused by different healthcare practitioners to provide collaborative patient care is demonstrated. This solution provides orchestration among different services by extracting data from sources like patient databases, clinical knowledge bases and evidence-based clinical guidelines (CGs) in order to facilitate multiple CDS requests coming from different healthcare settings. This architecture aims to aid users at different levels of Healthcare Delivery Organizations (HCOs) to maintain a CDS repository, along with monitoring and managing services, thus enabling transparency. The research employs the Design Science research methodology (DSRM) combined with The Open Group Architecture Framework (TOGAF), an open source group initiative for Enterprise Architecture Framework (EAF). DSRM's iterative capability addresses the rapidly evolving nature of workflows in healthcare. This SOA based solution uses standards-based open source technologies and platforms, the latest healthcare standards by HL7 and OMG, Decision Support Service (DSS) and Retrieve, Update Locate Service (RLUS) standard. Combining business process management (BPM) technologies, business rules with SOA ensures the HCO's capability to manage its processes. This architectural solution is evaluated by successfully implementing evidence based CGs at the point of care in areas such as; a) Diagnostics (Chronic Obstructive Disease), b) Urgent Referral (Lung Cancer), c) Genome testing and integration with CDS in screening (Lynch's syndrome). In addition to medical care, the CDS solution can benefit organizational processes for collaborative care delivery by connecting patients, physicians and other associated members. This framework facilitates integration of different types of CDS ideal for the different healthcare processes, enabling sharable CDS capabilities within and across organizations.

A Atenção Primária à Saúde é reconhecida como base para um sistema de informação em saúde (SIS) eficiente, razão pela qual justifica-se a importância de reestruturação a fim de atender os novos conceitos tecnológicos de integração das informações e interoperabilidade entre os SIS. Tal relevância resultou na Estratégia e-SUS AB composta: pelo Sistema de Informação em Saúde para Atenção Básica (SISAB); e pelo e-SUS AB. Dessa maneira, passou a ser o SIS vigente para fins de financiamento e de adesão aos programas de estratégias da Política Nacional de Atenção Básica. A pluralidade dos cenários de informatização e conectividade resultou na disponibilização de dois sistemas de software - Coleta de Dados Simplificada (CDS) e Prontuário Eletrônico do Cidadão -, responsáveis por alimentar o SISAB. Relatos de usuários do e-SUS AB identificaram falhas na capacitação e dificuldades para sanar dúvidas, reforçando a importância de uma educação permanente para qualificar as práticas em saúde, além da imprescindibilidade de olhar para as possíveis lacunas nos sistemas próprios. Este estudo teve como objetivos: elaborar um protótipo com oportunidades de melhorias para o módulo CDS do e-SUS AB, integrado no sistema proprietário utilizado no local da pesquisa; e desenvolver e avaliar um manual web, elaborado a partir de um diagnóstico de dúvidas e dificuldades dos agentes comunitários de saúde (ACS). Trata-se de uma pesquisa aplicada, com abordagem qualitativa, na modalidade pesquisa-ação. A população amostral foi constituída pelos ACS alocados em seis Núcleos da Saúde da Família do distrito Oeste do município de Ribeirão Preto e por especialistas de informática, que aceitaram participar da pesquisa por meio da assinatura do Termo de Consentimento Livre e Esclarecido. A coleta de dados ocorreu mediante observação das atividades do ACS utilizando o sistema e-SUS AB, módulo CDS, além de entrevistas não estruturadas. Para o desenvolvimento do protótipo foi utilizado o programa AXURE RP Pro 7.0, que gera protótipos interativos e para o desenvolvimento do manual web foi utilizado linguagem de marcação interpretada por navegadores. Tanto o protótipo quanto o manual web e-SUS foram avaliados por meio de aplicação de questionário. Os resultados evidenciam a importância de conhecer os aspectos relacionados ao modo de trabalho, ou de comportamento, que possam influenciar na qualidade final dos dados inseridos nos SIS. Da mesma maneira, visam a obter insumos para a definição dos requisitos e metas de usabilidade, a fim de atender os diferentes papéis-de-usuário identificados e, ainda, reforça a relevância de olhar para os sistemas próprios, adquiridos no mercado privado ou desenvolvidos no município. A aproximação entre o pesquisador e as pessoas implicadas na situação investigada proporcionou detectar lacunas entre os componentes indispensáveis para efetivar as ações que objetivam a consolidação da informatização em saúde e, sobretudo, delinear potenciais soluções para os problemas apontados / Primary Health Care is recognized as the basis for an efficient health information system, highlighting the importance of restructuring in order to meet the new technological concepts of information integration and interoperability among SIS. This action resulted in the e-SUS AB Strategy composed by the Health Information System for Basic Care (SISAB) and e-SUS AB and became the current health information system for funding and adherence to National Policy strategies programs of Basic Attention. The plurality of computerization and connectivity scenarios resulted in the availability of two software systems: Simplified Data Collection (CDS) and Electronic Health Record, responsible for feeding SISAB. Reports from users of e-SUS AB identified deficiencies in training and difficulties to resolve doubts, reinforcing the importance of a permanent education to qualify health practices beyond the importance of looking at possible gaps in the systems themselves. The purpose of this study was to develop a prototype with improvement opportunities for the CDS module of e-SUS AB, integrated in the proprietary system used at the research site, and to develop and evaluate a web manual, based on a diagnosis of doubts and difficulties of community health agents (ACS). This is an applied research, with a qualitative approach, in the research-action modality. The sample population consisted of the ACS assigned to six Family Health Centers of the western district of the city of Ribeirão Preto and by computer specialists, who agreed to participate in the study through the signing of the Informed Consent Term. Data collection was based on the observation of ACS activities using the e-SUS AB system, CDS module, in addition to unstructured interviews. For the prototype development, the AXURE RP Pro 7.0 program was used, which generates interactive prototypes and for the web manual development, it was used marking language interpreted by browsers. Both the prototype and the e-SUS web manual were evaluated through a questionnaire application. The results show the importance of knowing the aspects related to the way of work, or behavior, that can influence the final quality of the data inserted in the health information system as well as to obtain inputs for the definition of usability requirements and goals, in order to meet the different Identified user roles. Also reinforces the importance of looking at the own systems, acquired in the private market or developed in the municipality. The approximation between the researcher and the people involved in the investigated situation revealed gaps between the indispensable components to carry out the actions that aim at the consolidation of the informatization in health and the delineation of potential solutions to the mentioned problems