Slide1: Ontological Principles of Disease Management from Public Health Perspective: A tuberculosis Case Study Dr. Anjana Roy Anand Kumar Faculty of Medicine, University of Leipzig, Leipzig, Germany Julius Weinberg, Patty Kostkova, Gemma Madle City ehealth Research Centre, City University, London, UK Ewart Carson MIM, City University, London, UK \\b


Slide2: Public health &TB care pathway as a case study Proposed Ontology of TB care pathway Digital Library – National electronic Library for Infectious Diseases (NeLI) & ontology of the TB care pathway Future work Outline of presentation


Slide3: Public health &TB care pathway as a case study


Slide4: With the right outcome In the right place The right people In the right order Doing the right thing At the right time Integrated care pathways are a tool and a concept that embed guidelines, protocols and locally agreed evidence-based, patient-centred, best practice, into everyday use for the individual. The Integrated Care Pathways intends to have the following : What is an integrated care pathway?


Slide5: Why have we chosen TB?


Slide6: Interactive graphical representation of a TB care pathway


Slide7: Entities and processes described for the actual disease


Slide9: Heaf’s test Mantoux test Depending on severity of disease close contacts will be screened Chest X-ray Vaccination Early detection – prevent TB to develop to its most severe form Treating people who are infectious carriers of the disease


Slide10: Treatment


Slide11: Proposed Ontology of TB care pathway


Slide12: Why develop an ontology? Share common understanding of the structure of information among people To analyse domain knowledge To make domain assumptions explicit Allow reuse of the domain knowledge To separate domain knowledge from the operational knowledge A common vocabulary for researchers who need to share a information in a domain (Noy & McGuinness 2001) Definition of Ontology


Slide13: Defining classes in the ontology By defining individual instances of the classes & filling specific slot value information and additional slot restriction will result in creating a knowledge base What are the steps involved in developing an ontology?


Slide14: Ontological Representation of the entities of the Care Pathways Disease & diagnosis Pathology Investigation Prevention Treatment Control


Slide15: Tuberculosis pathological process Tuberculosis Tuberculosis pathology Disease, pathology & pathological process their ontological relationship


Slide16: Organisms Sub-cellular organelles Organisms Cells Tissues Organs Organ Systems Inclusion bodies Patient Granulomas Cell destruction Tuberculous nodules Respiratory system Disease Tuberculosis Pathology Phenomena Level affected – level of granularity Process: Pathology


Slide17: Investigation


Slide18: PREVENTION Vaccination Treating patients promptly Ensuring close contacts of people are seen promptly in the chest clinic Isoniazid for prevention Prevention


Slide19: Ontology of treatment based on HL7 RIM providing various moods Definitional mood Intent mood Request mood Event mood Criteria mood Goal mood


Slide20: Control economic, economic, Age Contact with tuberculosis patients Immune system is weakened by HIV or steroids Alcoholics Living in un-hygienic cramped condition Regional National International Local Targets- Risks of infection Levels of controls Control -Infection


Slide21: Population movement process depends on: Bearers Control Control - Transmission


Slide22: Digital Library – National electronic Library for Infectious Diseases (NeLI) & ontology of the TB care pathway


Slide23: Patient values Patient’s condition Evidence Choice Model for decision making (Muir Gray, JA. & de Lusigan, S. 1999) The ultimate aim of the NeLI is to provide quality assured evidence based medical knowledge, reviewed by clinical and non-clinical professional - the TB care pathway is the beginning of addition of care pathway of information available at the site.


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Slide26: Care pathways protocol and NeLI In future NeLI intend to provide an integrated national point of accessing and disseminating clinical protocols and integrated care pathways for infectious diseases .


Slide27: Future Work