Indexing the Event Calculus: Towards practical human-readable Personal Health Systems

Personal Health Systems (PHS) are mobile solutions tailored to monitoring patients affected by chronic non communicable diseases. In general, a patient affected by a chronic disease can generate large amounts of events: for example, in Type 1 Diabetic patients generate several glucose events per day, ranging from at least 6 events per day (under normal monitoring) to 288 per day when wearing a continuous glucose monitor (CGM) that samples the blood every 5 minutes for several days. Just by itself, without considering other physiological parameters, it would be impossible for medical doctors to individually and accurately follow every patient, highlighting the need of simple approaches towards querying physiological time series. Achieving this with current technology is not an easy task, as on one hand it cannot be expected that medical doctors have the technical knowledge to query databases and on the other hand these time series include thousands of events, which requires to re-think the way data is indexed. Anyhow, handling data streams efficiently is not enough. Domain experts' knowledge must be explicitly included into PHSs in a way that it can be easily readed and modified by medical staffs. Logic programming represents the perfect programming paradygm to accomplish this task. In this work, an Event Calculus-based reasoning framework to standardize and express domain-knowledge in the form of monitoring rules is suggested, and applied to three different use cases. However, if online monitoring has to be achieved, the reasoning performance must improve dramatically. For this reason, three promising mechanisms to index the Event Calculus Knowledge Base are proposed. All of them are based on different types of tree indexing structures: k-d trees, interval trees and red-black trees. The paper then compares and analyzes the performance of the three indexing techniques, by computing the time needed to check different type of rules (and eventually generating alerts), when the number of recorded events (e.g. values of physiological parameters) increases. The results show that customized jREC performs much better when the event average inter-arrival time is little compared to the checked rule time-window. Instead, where the events are more sparse, the use of k-d trees with standard EC is advisable. Finally, the Multi-Agent paradigm helps to wrap the various components of the system: the reasoning engines represent the agent minds, and the sensors are its body. The said agents have been developed in MAGPIE, a mobile event based Java agent platform.

[1]  Rudolf Bayer,et al.  Symmetric binary B-Trees: Data structure and maintenance algorithms , 1972, Acta Informatica.

[2]  Marcello Ferro,et al.  Personal Health System architecture for stress monitoring and support to clinical decisions , 2012, Comput. Commun..

[3]  P. Briss,et al.  Prevention of chronic disease in the 21st century: elimination of the leading preventable causes of premature death and disability in the USA , 2014, The Lancet.

[4]  Jon Louis Bentley,et al.  Multidimensional binary search trees used for associative searching , 1975, CACM.

[5]  Alexander Artikis,et al.  An Event Calculus for Event Recognition , 2015, IEEE Transactions on Knowledge and Data Engineering.

[6]  Upkar Varshney,et al.  Pervasive Healthcare and Wireless Health Monitoring , 2007, Mob. Networks Appl..

[7]  David Sánchez,et al.  Agents applied in health care: A review , 2010, Int. J. Medical Informatics.

[8]  Aldo Franco Dragoni,et al.  Combining Artificial Intelligence and NetMedicine for Ambient Assisted Living: A Distributed BDI-based Expert System , 2015, Int. J. E Health Medical Commun..

[9]  Luca Chittaro,et al.  Modeling Medical Reasoning with the Event Calculus: An Application to the Management of Mechanical Ventilation , 1995, AIME.

[10]  Giorgio C. Buttazzo,et al.  Non-intrusive Patient Monitoring for Supporting General Practitioners in Following Diseases Evolution , 2015, IWBBIO.

[11]  Andrea Omicini,et al.  Towards the Adoption of Agent-Based Modelling and Simulation in Mobile Health Systems for the Self-Management of Chronic Diseases , 2016, WOA.

[12]  Esther Rodríguez-Villegas,et al.  COMMODITY12: A smart e-health environment for diabetes management , 2013, J. Ambient Intell. Smart Environ..

[13]  Eugenio Di Sciascio,et al.  Semantic-Based Resource Discovery and Orchestration in Home and Building Automation: A Multi-Agent Approach , 2014, IEEE Transactions on Industrial Informatics.

[14]  D H Spodick Normal sinus heart rate: appropriate rate thresholds for sinus tachycardia and bradycardia. , 1996, Southern medical journal.

[15]  René Schumann,et al.  An expert Personal Health System to monitor patients affected by Gestational Diabetes Mellitus: A feasibility study , 2016, J. Ambient Intell. Smart Environ..

[16]  Antonio Moreno,et al.  A Systematic Literature Review of Agents Applied in Healthcare , 2016, Journal of Medical Systems.

[17]  Samia Nefti,et al.  Cognitive agent based intelligent warning system to monitor patients suffering from dementia using ambient assisted living , 2010, 2010 International Conference on Information Society.

[18]  Albert Brugués de la Torre,et al.  MAGPIE: an agent platform for the development of mobile applications for pervasive healthcare , 2014, AI-AM/NetMed@ECAI.

[19]  K. Dungan,et al.  Monitoring Technologies – Continuous Glucose Monitoring, Mobile Technology, Biomarkers of Glycemic Control , 2014 .

[20]  Giorgio C. Buttazzo,et al.  Agent-Based Systems for Telerehabilitation: Strengths, Limitations and Future Challenges , 2017, A2HC@AAMAS/A-HEALTH@PAAMS.

[21]  Paolo Sernani,et al.  Exploring the ambient assisted living domain: a systematic review , 2017, J. Ambient Intell. Humaniz. Comput..

[22]  Angelo Montanari,et al.  EFFICIENT TEMPORAL REASONING IN THE CACHED EVENT CALCULUS , 1996, Comput. Intell..

[23]  Angelo Montanari,et al.  The event calculus at work: a case study in the medical domain , 1994 .

[24]  Alexander Peine,et al.  Valuing health technology – habilitating and prosthetic strategies in personal health systems , 2015 .

[25]  Gnana Bharathy,et al.  A systems approach to healthcare: Agent-based modeling, community mental health, and population well-being , 2015, Artif. Intell. Medicine.

[26]  Seth Flaxman,et al.  European Union Regulations on Algorithmic Decision-Making and a "Right to Explanation" , 2016, AI Mag..

[27]  Giorgio C. Buttazzo,et al.  The challenge of real-time multi-agent systems for enabling IoT and CPS , 2017, WI.

[28]  P. Zimmet,et al.  Diabetes mellitus statistics on prevalence and mortality: facts and fallacies , 2016, Nature Reviews Endocrinology.

[29]  Albert Brugués de la Torre,et al.  Indexing the Event Calculus with Kd-trees to Monitor Diabetes , 2017, ArXiv.

[30]  Farid Touati,et al.  U-Healthcare System: State-of-the-Art Review and Challenges , 2013, Journal of Medical Systems.

[31]  Erik T. Mueller,et al.  Commonsense Reasoning: An Event Calculus Based Approach , 2006 .

[32]  Marek J. Sergot,et al.  A logic-based calculus of events , 1989, New Generation Computing.

[33]  Albert Brugués de la Torre,et al.  Processing Diabetes Mellitus Composite Events in MAGPIE , 2016, Journal of Medical Systems.

[34]  Sarvapali D. Ramchurn,et al.  Agent-based control for decentralised demand side management in the smart grid , 2011, AAMAS.

[35]  Mark de Berg,et al.  Computational geometry: algorithms and applications , 1997 .

[36]  Paola Mello,et al.  Reactive Event Calculus for Monitoring Global Computing Applications , 2012, Logic Programs, Norms and Action.