Diagnosis, misdiagnosis, lucky guess, hearsay, and more: an ontological analysis

A realism-based approach to an ontological representation of symbiotic interactions

Background

The symbiotic interactions that occur between humans and organisms in our environment have a tremendous impact on our health. Recently, there has been a surge in interest in understanding the complex relationships between the microbiome and human health and host immunity against microbial pathogens, among other things. To collect and manage data about these interactions and their complexity, scientists will need ontologies that represent symbiotic interactions as they occur in reality.

Methods

We began with two papers that reviewed the usage of ‘symbiosis’ and related terms in the biology and ecology literature and prominent textbooks. We then analyzed several prominent standard terminologies and ontologies that contain representations of symbiotic interactions, to determine if they appropriately defined ‘symbiosis’ and related terms according to current scientific usage as identified by the review papers. In the process, we identified several subtypes of symbiotic interactions, as well as the characteristics that differentiate them, which we used to propose textual and axiomatic definitions for each subtype of interaction. To both illustrate how to use the ontological representations and definitions we created and provide additional quality assurance on key definitions, we carried out a referent tracking analysis and representation of three scenarios involving symbiotic interactions among organisms.

Results

We found one definition of ‘symbiosis’ in an existing ontology that was consistent with the vast preponderance of scientific usage in biology and ecology. However, that ontology changed its definition during the course of our work, and discussions are ongoing. We present a new definition that we have proposed. We also define 34 subtypes of symbiosis. Our referent tracking analysis showed that it is necessary to define symbiotic interactions at the level of the individual, rather than at the species level, due to the complex nature in which organisms can go from participating in one type of symbiosis with one organism to participating in another type of symbiosis with a different organism.

Conclusion

As a result of our efforts here, we have developed a robust representation of symbiotic interactions using a realism-based approach, which fills a gap in existing biomedical ontologies.

Enhancing the Representational Power of i2b2 through Referent Tracking

The Informatics for Integrating Biology and the Bedside (i2b2) software platform has proven successful in leveraging clinical enterprise data for the identification of cohorts of patients satisfying certain demographic, phenotypic and genetic criteria in support of further studies. An unanswered question thus far is whether i2b2 search criteria could include characteristics of assertions themselves, e.g. diagnoses, rather than what the assertions (observations) are about, e.g. diseases. This would allow, for instance, to find cohorts of patients for which different providers have been in disagreement about what condition the patient is suffering from. Previous research has shown that this requires more explicit detail about, and unique identification of, two sorts of entities: those that directly or indirectly contribute to the coming into existence of such observations and those that are either explicitly mentioned or merely implied in the assertions. Our research here demonstrates that i2b2's modifier system can be used to represent the relationships between observations and their explicit or implied referents on the one hand, and between relevant referents themselves on the other hand, both in combination with the storage of explicit unique instance identifiers for these observations and referents in i2b2's fact table. While this approach adheres to i2b2's base functionality and implementation specifications, it makes explicit ambiguities and confusions that would otherwise remain undetected.

Diseases diagnosis using fuzzy logic methods: A systematic and meta-analysis review

BACKGROUND AND OBJECTIVE

Diagnosis as the initial step of medical practice, is one of the most important parts of complicated clinical decision making which is usually accompanied with the degree of ambiguity and uncertainty. Since uncertainty is the inseparable nature of medicine, fuzzy logic methods have been used as one of the best methods to decrease this ambiguity. Recently, several kinds of literature have been published related to fuzzy logic methods in a wide range of medical aspects in terms of diagnosis. However, in this context there are a few review articles that have been published which belong to almost ten years ago. Hence, we conducted a systematic review to determine the contribution of utilizing fuzzy logic methods in disease diagnosis in different medical practices.

METHODS

Eight scientific databases are selected as an appropriate database and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was employed as the basis method for conducting this systematic and meta-analysis review. Regarding the main objective of this research, some inclusion and exclusion criteria were considered to limit our investigation. To achieve a structured meta-analysis, all eligible articles were classified based on authors, publication year, journals or conferences, applied fuzzy methods, main objectives of the research, problems and research gaps, tools utilized to model the fuzzy system, medical disciplines, sample sizes, the inputs and outputs of the system, findings, results and finally the impact of applied fuzzy methods to improve diagnosis. Then, we analyzed the results obtained from these classifications to indicate the effect of fuzzy methods in decreasing the complexity of diagnosis.

RESULTS

Consequently, the result of this study approved the effectiveness of applying different fuzzy methods in diseases diagnosis process, presenting new insights for researchers about what kind of diseases which have been more focused. This will help to determine the diagnostic aspects of medical disciplines that are being neglected.

CONCLUSIONS

Overall, this systematic review provides an appropriate platform for further research by identifying the research needs in the domain of disease diagnosis.

Improving the 'Fitness for Purpose' of Common Data Models through Realism Based Ontology

Common data models are designed and built based on requirements that are aimed towards fitness for purpose. But when common data models are used as lenses through which reality is observed from the perspective according to which they are built, then they exhibit restrictions that distort such view. Realism-based ontology design, when done properly, does not have these limitations as its fitness for purpose is only determined by the degree to which reality is represented the way it is. Therefore, we can use the principles that realism-based ontologies adhere to, not only to design application ontologies serving some specific purpose, but also to assess whether and where common data models fall short in their representational adequacy and how they can be corrected. If a realism based ontological perspective on the portion of reality the some common data model is trying to represent is compared with the perspective of the common data model itself, it is possible to determine how the latter deviates from the former and to suggest solutions to correct the misrepresentations found. Applying this method to the common data model of the Observational Medical Outcomes Partnership, revealed two major categories of errors: one where relationships are restricted based on the constraints of the data model, and one where the representation of reality is oversimplified.

The Problems of Realism-Based Ontology Design: a Case Study in Creating Definitions for an Application Ontology for Diabetes Camps

A requirement of realism-based ontology design is that classes denote exclusively entities that exist objectively in reality and that their definitions adhere to strict criteria to ensure that the classes are re-usable in other ontologies while preserving their ontological commitment. Building realism-based ontologies is therefore quite challenging and time-consuming, demanding considerable training. Although the top-level in the form of the Basic Formal Ontology (BFO) is worked out very well, and also the upper levels of certain domains, there is still a disconnect with the bottom- up or middle-out approach which is typical, and more practical, for application ontologies. Using the development of an application ontology for diabetes management in diabetes camps as an example, we present an overview of problems trainees in realism-based ontology design can be confronted with and offer some guidelines on how to deal with them in case no ideal solution is available.