Automatic Rule Generation for Decision-Making in Context-Aware Systems Using Machine Learning.

With the increasing interest devoted to dynamic environments, a crucial aspect is revealed in context-aware systems to deal with the rapid changes occurring in users' surrounding environments at runtime. However, most context-aware systems with predefined context-aware rules may not support effective decision-making in dynamic environments. These context-aware rules, which take into account different context information to reach an appropriate decision, could lose their efficiency at runtime. Therefore, a growing need is emerging to address the decision-making issue leveraged by dynamic environments. To tackle this issue, we present an approach that relies on improving decision-making in the wake of dynamic environments through automatically enriching a rule knowledge base with new context-aware rules discovered at runtime. The major features of the presented approach are as follows: (i) a hybridization of two machine learning algorithms for rule generation, (ii) an extended genetic algorithm (GA) for rule optimization, and (iii) a rule transformation for the knowledge base enrichment in an automated manner. Furthermore, extensive experiments on different datasets are performed to assess the effectiveness of the presented approach. The obtained experimental results depict that this approach exhibits better effectiveness compared to some algorithms and state-of-the-art works.

Generation of reusable learning objects from digital medical collections: An analysis based on the MASMDOA framework.

Learning Objects represent a widespread approach to structuring instructional materials in a large variety of educational contexts. The main aim of this work consists of analyzing the process of generating reusable learning objects followed by Clavy, a tool that can be used to retrieve data from multiple medical knowledge sources and reconfigure such sources in diverse multimedia-based structures and organizations. From these organizations, Clavy is able to generate learning objects that can be adapted to various instructional healthcare scenarios with several types of user profiles and distinct learning requirements. Moreover, Clavy provides the capability of exporting these learning objects through standard educational specifications, which improves their reusability features. The analysis proposed is conducted following criteria defined by the MASMDOA framework for comparing and selecting learning object generation methodologies. The analysis insights highlight the importance of having a tool to transfer knowledge from the available digital medical collections to learning objects that can be easily accessed by medical students and healthcare practitioners through the most popular e-learning platforms.

Generation of Standardized E-Learning Content from Digital Medical Collections.

In this paper, we describe a new approach to generating standardized e-Learning content from existing medical collections. The core of this approach is a tool called Clavy, which makes it possible to retrieve information items from medical collections, to transform these items into meaningful learning units, and to export them in the form of standardized e-Learning packages. In addition to describing the approach, we assess its feasibility by applying it to the generation of IMS Content Packages from MedPix, an online database of medical cases in the domain of radiology.

Effects of online palliative care training on knowledge, attitude and satisfaction of primary care physicians.

BACKGROUND: The Spanish Palliative Care Strategy recommends an intermediate level of training for primary care physicians in order to provide them with knowledge and skills. Most of the training involves face-to-face courses but increasing pressures on physicians have resulted in fewer opportunities for provision of and attendance to this type of training. The effectiveness of on-line continuing medical education in terms of its impact on clinical practice has been scarcely studied. Its effect in relation to palliative care for primary care physicians is currently unknown, in terms of improvement in patient's quality of life and main caregiver's satisfaction. There is uncertainty too in terms of any potential benefits of asynchronous communication and interaction among on-line education participants, as well as of the effect of the learning process.The authors have developed an on-line educational model for palliative care which has been applied to primary care physicians in order to measure its effectiveness regarding knowledge, attitude towards palliative care, and physician's satisfaction in comparison with a control group.The effectiveness evaluation at 18 months and the impact on the quality of life of patients managed by the physicians, and the main caregiver's satisfaction will be addressed in a different paper. METHODS: Randomized controlled educational trial to compared, on a first stage, the knowledge and attitude of primary care physicians regarding palliative care for advanced cancer patients, as well as satisfaction in those who followed an on-line palliative care training program with tutorship, using a Moodle Platform vs. traditional education. RESULTS: 169 physicians were included, 85 in the intervention group and 84 in the control group, of which five were excluded. Finally 82 participants per group were analyzed. There were significant differences in favor of the intervention group, in terms of knowledge (mean 4.6; CI 95%: 2.8 to 6.5 (p = 0.0001), scale range 0-33), confidence in symptom management (p = 0.02) and confidence in terms of communication (p = 0.038). Useful aspects were pointed out, as well as others to be improved in future applications. The satisfaction of the intervention group was high. CONCLUSIONS: The results of this study show that there was a significant increase of knowledge of 14%-20% and a significant increase in the perception of confidence in symptom management and communication in the intervention group in comparison with the control group that received traditional methods of education in palliative care or no educational activity at all. The overall satisfaction with the intervention was good-very good for most participants.This on-line educational model seems a useful tool for palliative care training in primary care physicians who have a high opinion about the integration of palliative care within primary care. The results of this study support the suggestion that learning effectiveness should be currently investigated comparing different Internet interventions, instead of Internet vs. no intervention.