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709 results on '"Stefanelli, M."'

158. A specialized framework for Medical Diagnostic Knowledge Based Systems

Author

Lanzola, G. and Stefanelli, M.

Subjects
User-Computer Interface, Artificial Intelligence, Software Design, Diagnosis, Computer-Assisted, Models, Theoretical, Problem Solving, Research Article
Abstract

To have a knowledge based system (KBS) exhibiting an intelligent behavior, it must be endowed even with knowledge able to represent the expert's strategies, other than with domain knowledge. The elicitation task is inherently difficult for strategic knowledge, because strategy is often tacit, and, even when it has been made explicit, it is not an easy task to describe it in a form that may be directly translated and implemented into a program. This paper describes a Specialized Framework for Medical Diagnostic Knowledge Based Systems able to help an expert in the process of building KBSs in a medical domain. The framework is based on an epistemological model of diagnostic reasoning which has proved to be helpful in describing the diagnostic process in terms of the tasks by which it is composed of.

Published
1991

162. The M2DM Project

Author

Bellazzi, R., primary, Stefanelli, M., primary, Ferrari, P., primary, De Cata, P., primary, Gazzaruso, C., primary, Fratino, P., primary, D’Annunzio, G., primary, Hernando, E., primary, Gomez, E.J., primary, and Larizza, C., additional

Published
2006
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177. Comparing Computer-interpretable Guideline Models: A Case-study Approach

Author

Peleg, M., primary, Tu, S., additional, Bury, J., additional, Ciccarese, P., additional, Fox, J., additional, Greenes, R. A., additional, Hall, R., additional, Johnson, P. D., additional, Jones, N., additional, Kumar, A., additional, Miksch, S., additional, Quaglini, S., additional, Seyfang, A., additional, Shortliffe, E. H., additional, and Stefanelli, M., additional

Published
2003
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178. An ontology-based framework for guideline-driven medical practice

Author

Quaglini, S, Dazzi, L, Saracco, R, Stefanelli, M, Locatelli, Franco, Locatelli, F (ORCID:0000-0002-7976-3654), Quaglini, S, Dazzi, L, Saracco, R, Stefanelli, M, Locatelli, Franco, and Locatelli, F (ORCID:0000-0002-7976-3654)

Abstract

This paper describes a general framework for clinical practice guidelines development, dissemination and use. We propose an ontological description of the medical knowledge and of the organizational context, in order to produce clinical guidelines which, on one hand, can be widely shared between different institutions and, on the other, can be efficiently tailored to consider the peculiarities of each clinical context.

Published
1997

180. Computerised Guidelines Implementation: Obtaining Feedback for Revision of Guidelines, Clinical Data Model and Data Flow.

Author

Carbonell, Jaime G., Siekmann, Jörg, Bellazzi, Riccardo, Abu-Hanna, Ameen, Hunter, Jim, Panzarasa, S., Quaglini, S., Cavallini, A., Marcheselli, S., Stefanelli, M., and Micieli, G.

Abstract

In this paper we describe a module that allows to collect (a) motivations for non-compliance to guidelines, (b) motivations for poor data entry into the electronic patient record, and (c) comments on medical aspects of guideline recommendations, on their formalisation into computerised rules, and on the guideline integration into the computerised clinical chart. We organised a well-structured taxonomy of non-compliance motivations in such a way that the main hierarchical levels correspond to different medical or technical roles suitable for feedback managing. We analysed about 400 consecutive cases of patients with ischemic stroke. About 40 non-compliances, as well as several incomplete data forms have been identified and motivated. [ABSTRACT FROM AUTHOR]

Published
2007
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182. Smooth Integration of Decision Support into an Existing Electronic Patient Record.

Author

Miksch, Silvia, Hunter, Jim, Keravnou, Elpida, Quaglini, S., Panzarasa, S., Cavallini, A., Micieli, G., Pernice, C., and Stefanelli, M.

Abstract

Willingness to use computerised decision support systems is often jeopardised by lack of effective integration into existing user interfaces for electronic patient record. Concepts illustrated in this paper stem from the need of developing a project for the comparison of the physicians' compliance to a clinical practice guideline before and after an electronic version of the guideline was introduced. Before starting the implementation, we performed a deep users' needs analysis. It was accomplished also on the basis of lesson learned on past guideline implementations. The new idea was to classify guideline suggestions on the basis of some attributes, whose values will determine the modality of presentation of the suggestion itself, and on a different management of non compliance advice. [ABSTRACT FROM AUTHOR]

Published
2005
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184. An influence diagram for assessing GVHD prophylaxis after bone marrow transplantation in children

Author

Quaglini, S, Bellazzi, R, Locatelli, Franco, Stefanelli, M, Salvaneschi, C, Locatelli, F (ORCID:0000-0002-7976-3654), Quaglini, S, Bellazzi, R, Locatelli, Franco, Stefanelli, M, Salvaneschi, C, and Locatelli, F (ORCID:0000-0002-7976-3654)

Abstract

Graft-versus-host disease (GVHD) represents one of the major complications of allogeneic bone marrow transplantation (BMT). Nevertheless, the occurrence of mild GVHD could be desirable in high-risk leukemic patients, due to a relapse-preventing effect known as the graft-versus-leukemia (GVL) effect. Given that different prophylactic interventions are available to prevent GVHD development, the decision problem consists in assessing both type and dosage of the drugs in order to avoid or induce GVHD, according to the specific patient's condition. The decision problem can be represented and solved by using an influence diagram. The choice of this formalism allows using new available methods for building and updating the model of the decision problem. The qualitative structure of the model and the conditional probabilities were first derived by combining literature results with a medical expert's judgement. More specifically, probabilities were initially assigned as ranges rather than as point values. Then, conditional probabilities were updated, by using a learning algorithm, as new cases became available. The authors analyzed 50 cases of pediatric patients affected by either malignant or nonmalignant diseases, undergoing BMT and receiving GVHD prophylaxis. They used the first 25 cases to adjust the initially assigned conditional probabilities, then checked the model obtained on the remaining patients. The overall performance for GVHD prediction was about 80%.

Published
1994

185. Chronic anisakidosis presenting with intestinal intussusception.

Author

PISCAGLIA, A. C., VENTURA, M. T., LANDOLFO, G., GIORDANO, M., RUSSO, S., LANDI, R., ZULIAN, V., FORTE, F., and STEFANELLI, M. L.

Abstract

OBJECTIVE: Anisakidosis is a parasitic infection caused by the ingestion of row or uncooked fish, containing larval nematodes from the Anisakidae family. Intestinal anisakidosis represents about 4% of all cases, the majority being localized in the small bowel, with rare colonic involvement. Here we present an infrequent case of chronic anisakidosis, presenting with intestinal intussusception. CASE REPORT: A 52 years old woman, chronically treated with immunosuppressants, presented to our Institution with acute abdominal pain and vomiting, due to colocolic intussusception. Colonoscopy successfully reduced the intussusception and revealed the presence of a voluminous colonic submucosal mass, near the hepatic flexure. Therefore, the patient underwent laparoscopic right hemicolectomy. The diagnosis of anisakidosis was made when the histological examination of the surgical specimen revealed the infestation of the intestinal wall by a nematode of the Anisakidae family, with an intense erosive-inflammatory adjacent reaction. [ABSTRACT FROM AUTHOR]

Published
2014

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