Healthcare applications with the Internet of Things (IoT) are often safety-critical, thus, require extensive testing. Such applications are often connected to smart medical devices from various vendors. System-level testing of such applications requires test infrastructures physically integrating medical devices, which is time and monetary-wise expensive. Moreover, applications continuously evolve, e.g., introducing new devices and users and updating software. Nevertheless, a test infrastructure enabling testing with a few devices is insufficient for testing healthcare IoT systems, hence compromising their dependability. In this paper, we propose a model-based approach for the creation and operation of digital twins (DTs) of medicine dispensers as a replacement for physical devices to support the automated testing of IoT applications at scale. We evaluate our approach with an industrial IoT system with medicine dispensers in the context of Oslo City and its industrial partners, providing healthcare services to its residents. We study the fidelity of DTs in terms of their functional similarities with their physical counterparts: medicine dispensers. Results show that the DTs behave
The medical ecosystem consists of the training of new clinicians and researchers, the practice of clinical medicine, and areas of adjacent research. There are many aspects of these domains that could benefit from the application of task automation and programmatic assistance. Machine learning and artificial intelligence techniques, including large language models (LLMs), have been promised to deliver on healthcare innovation, improving care speed and accuracy, and reducing the burden on staff for manual interventions. However, LLMs have no understanding of objective truth that is based in reality. They also represent real risks to the disclosure of protected information when used by clinicians and researchers. The use of AI in medicine in general, and the deployment of LLMs in particular, therefore requires careful consideration and thoughtful application to reap the benefits of these technologies while avoiding the dangers in each context.
As the population grows, the need for a quality level of medical services grows correspondingly, so does the demand for information technology in medicine. The concept of "Smart Healthcare" offers many approaches aimed at solving the acute problems faced by modern healthcare. In this paper, we review the main problems of modern healthcare, analyze existing approaches and technologies in the areas of digital twins, the Internet of Things and mobile medicine, determine their effectiveness in solving the set problems, consider the technologies that are used to monitor and treat patients and propose the concept of the Smart Healthcare platform.
What does Artificial Intelligence (AI) have to contribute to health care? And what should we be looking out for if we are worried about its risks? In this paper we offer a survey, and initial evaluation, of hopes and fears about the applications of artificial intelligence in medicine. AI clearly has enormous potential as a research tool, in genomics and public health especially, as well as a diagnostic aid. It's also highly likely to impact on the organisational and business practices of healthcare systems in ways that are perhaps under-appreciated. Enthusiasts for AI have held out the prospect that it will free physicians up to spend more time attending to what really matters to them and their patients. We will argue that this claim depends upon implausible assumptions about the institutional and economic imperatives operating in contemporary healthcare settings. We will also highlight important concerns about privacy, surveillance, and bias in big data, as well as the risks of over trust in machines, the challenges of transparency, the deskilling of healthcare practitioners, the way AI reframes healthcare, and the implications of AI for the distribution of power in healthcare ins
In today's complex healthcare landscape, the pursuit of delivering optimal patient care while navigating intricate economic dynamics poses a significant challenge for healthcare service providers (HSPs). In this already complex dynamics, the emergence of clinically promising personalized medicine based treatment aims to revolutionize medicine. While personalized medicine holds tremendous potential for enhancing therapeutic outcomes, its integration within resource-constrained HSPs presents formidable challenges. In this study, we investigate the economic feasibility of implementing personalized medicine. The central objective is to strike a balance between catering to individual patient needs and making economically viable decisions. Unlike conventional binary approaches to personalized treatment, we propose a more nuanced perspective by treating personalization as a spectrum. This approach allows for greater flexibility in decision-making and resource allocation. To this end, we propose a mathematical framework to investigate our proposal, focusing on Bladder Cancer (BC) as a case study. Our results show that while it is feasible to introduce personalized medicine, a highly effici
From medical charts to national census, healthcare has traditionally operated under a paper-based paradigm. However, the past decade has marked a long and arduous transformation bringing healthcare into the digital age. Ranging from electronic health records, to digitized imaging and laboratory reports, to public health datasets, today, healthcare now generates an incredible amount of digital information. Such a wealth of data presents an exciting opportunity for integrated machine learning solutions to address problems across multiple facets of healthcare practice and administration. Unfortunately, the ability to derive accurate and informative insights requires more than the ability to execute machine learning models. Rather, a deeper understanding of the data on which the models are run is imperative for their success. While a significant effort has been undertaken to develop models able to process the volume of data obtained during the analysis of millions of digitalized patient records, it is important to remember that volume represents only one aspect of the data. In fact, drawing on data from an increasingly diverse set of sources, healthcare data presents an incredibly comp
We compare the network of aggregated journal-journal citation relations provided by the Journal Citation Reports (JCR) 2012 of the Science and Social Science Citation Indexes (SCI and SSCI) with similar data based on Scopus 2012. First, global maps were developed for the two sets separately; sets of documents can then be compared using overlays to both maps. Using fuzzy-string matching and ISSN numbers, we were able to match 10,524 journal names between the two sets; that is, 96.4% of the 10,936 journals contained in JCR or 51.2% of the 20,554 journals covered by Scopus. Network analysis was then pursued on the set of journals shared between the two databases and the two sets of unique journals. Citations among the shared journals are more comprehensively covered in JCR than Scopus, so the network in JCR is denser and more connected than in Scopus. The ranking of shared journals in terms of indegree (that is, numbers of citing journals) or total citations is similar in both databases overall (Spearman's \r{ho} > 0.97), but some individual journals rank very differently. Journals that are unique to Scopus seem to be less important--they are citing shared journals rather than bein
Blockchain technology is one of the most contemporary and disruptive technologies in the world. It has gained considerable attention in numerous applications such as financial services, cybersecurity applications, Internet of Things (IoT), network data management. Now its range of applications is beyond the financial services as the healthcare industry has also adopted blockchain technology in its various subdomains such as Electronic Health Records (EHR), medical supply chain management system, genomic market, neuroscience technology, clinical research, and pharmaceutical medicine. Blockchain is considered a secure and viable solution for storing and accessing patients medical records and the patients can diagnosed and treated with safe and secure data sharing. Blockchain technology will revolutionize the healthcare systems with personalized, authentic, and secure access to the clinical data of patients and that data can be used for further health improvements and clinical researches. In this paper, we conduct a contemporary research on existing applications and developments in healthcare industry with the use of blockchain technology. We also discuss some robust applications and
Rankings of scholarly journals based on citation data are often met with skepticism by the scientific community. Part of the skepticism is due to disparity between the common perception of journals' prestige and their ranking based on citation counts. A more serious concern is the inappropriate use of journal rankings to evaluate the scientific influence of authors. This paper focuses on analysis of the table of cross-citations among a selection of Statistics journals. Data are collected from the Web of Science database published by Thomson Reuters. Our results suggest that modelling the exchange of citations between journals is useful to highlight the most prestigious journals, but also that journal citation data are characterized by considerable heterogeneity, which needs to be properly summarized. Inferential conclusions require care in order to avoid potential over-interpretation of insignificant differences between journal ratings. Comparison with published ratings of institutions from the UK's Research Assessment Exercise shows strong correlation at aggregate level between assessed research quality and journal citation `export scores' within the discipline of Statistics.
The rapid growth of healthcare data and advances in computational power have accelerated the adoption of artificial intelligence (AI) in medicine. However, AI systems deployed without explicit fairness considerations risk exacerbating existing healthcare disparities, potentially leading to inequitable resource allocation and diagnostic disparities across demographic subgroups. To address this challenge, we propose FairGrad, a novel gradient reconciliation framework that automatically balances predictive performance and multi-attribute fairness optimization in healthcare AI models. Our method resolves conflicting optimization objectives by projecting each gradient vector onto the orthogonal plane of the others, thereby regularizing the optimization trajectory to ensure equitable consideration of all objectives. Evaluated on diverse real-world healthcare datasets and predictive tasks - including Substance Use Disorder (SUD) treatment and sepsis mortality - FairGrad achieved statistically significant improvements in multi-attribute fairness metrics (e.g., equalized odds) while maintaining competitive predictive accuracy. These results demonstrate the viability of harmonizing fairness
The recent advancements in computing systems and wireless communications have made healthcare systems more efficient than before. Modern healthcare devices can monitor and manage different health conditions of the patients automatically without any manual intervention from medical professionals. Additionally, the use of implantable medical devices (IMDs), body area networks (BANs), and Internet of Things (IoT) technologies in healthcare systems improve the overall patient monitoring and treatment process. However, these systems are complex in software and hardware, and optimizing between security, privacy, and treatment is crucial for healthcare systems as any security or privacy violation can lead to severe effects on patients' treatments and overall health conditions. Indeed, the healthcare domain is increasingly facing security challenges and threats due to numerous design flaws and the lack of proper security measures in healthcare devices and applications. In this paper, we explore various security and privacy threats to healthcare systems and discuss the consequences of these threats. We present a detailed survey of different potential attacks and discuss their impacts. Furth
Interdisciplinary research is critical for innovation and addressing complex societal issues. We characterise the interdisciplinary knowledge structure of PubMed research articles in medicine as correlation networks of medical concepts and compare the interdisciplinarity of articles between high-ranking (impactful) and less high-ranking (less impactful) medical journals. We found that impactful medical journals tend to publish research that are less interdisciplinary than less impactful journals. Observing that they bridge distant knowledge clusters in the networks, we find that cancer-related research can be seen as one of the main drivers of interdisciplinarity in medical science. Using signed difference networks, we also investigate the clustering of deviations between high and low impact journal correlation networks. We generally find a mild tendency for strong link differences to be adjacent. Furthermore, we find topic clusters of deviations that shift over time. In contrast, topic clusters in the original networks are static over time and can be seen as the core knowledge structure in medicine. Overall, journals and policymakers should encourage initiatives to accommodate int
Healthcare is one of the most promising areas for machine learning models to make a positive impact. However, successful adoption of AI-based systems in healthcare depends on engaging and educating stakeholders from diverse backgrounds about the development process of AI models. We present a broadly accessible overview of the development life cycle of clinical AI models that is general enough to be adapted to most machine learning projects, and then give an in-depth case study of the development process of a deep learning based system to detect aortic aneurysms in Computed Tomography (CT) exams. We hope other healthcare institutions and clinical practitioners find the insights we share about the development process useful in informing their own model development efforts and to increase the likelihood of successful deployment and integration of AI in healthcare.
The COVID-19 pandemic and other ongoing health crises have underscored the need for prompt healthcare services worldwide. The traditional healthcare system, centered around hospitals and clinics, has proven inadequate in the face of such challenges. Intelligent wearable devices, a key part of modern healthcare, leverage Internet of Things technology to collect extensive data related to the environment as well as psychological, behavioral, and physical health. However, managing the substantial data generated by these wearables and other IoT devices in healthcare poses a significant challenge, potentially impeding decision-making processes. Recent interest has grown in applying data analytics for extracting information, gaining insights, and making predictions. Additionally, machine learning, known for addressing various big data and networking challenges, has seen increased implementation to enhance IoT systems in healthcare. This chapter focuses exclusively on exploring the hurdles encountered when integrating ML methods into the IoT healthcare sector. It offers a comprehensive summary of current research challenges and potential opportunities, categorized into three scenarios: IoT
Machine learning (ML) transforms healthcare by enabling predictive analytics, personalized treatments, and improved patient outcomes. However, traditional ML workflows often require specialized skills, infrastructure, and resources, limiting accessibility for many healthcare professionals. This paper explores how BigQuery ML Cloud service helps healthcare researchers and data analysts to build and deploy models using SQL, without need for advanced ML knowledge. Our results demonstrate that the Boosted Tree model achieved the highest performance among the three models making it highly effective for diabetes prediction. BigQuery ML directly integrates predictive analytics into their workflows to inform decision-making and support patient care. We reveal this capability through a case study on diabetes prediction using the Diabetes Health Indicators Dataset. Our study underscores BigQuery ML's role in democratizing machine learning, enabling faster, scalable, and efficient predictive analytics that can directly enhance healthcare decision-making processes. This study aims to bridge the gap between advanced machine learning and practical healthcare analytics by providing detailed insig
Interdisciplinary research, a process of knowledge integration, is vital for scientific advancements. It remains unclear whether prestigious journals that are highly impactful lead in disseminating interdisciplinary knowledge. In this paper, by constructing topic-level correlation networks based on publications, we evaluated the interdisciplinarity of more and less prestigious journals in medicine. We found research from prestigious medical journals tends to be less interdisciplinary than research from other medical journals. We also established that cancer-related research is the main driver of interdisciplinarity in medical science. Our results indicate a weak tendency for differences in topic correlations between more and less prestigious journals to be co-located. Accordingly, we identified that interdisciplinarity in prestigious journals mainly differs from interdisciplinarity in other journals in areas such as infections, nervous system diseases and cancer. Overall, our results suggest that interdisciplinarity in science could benefit from prestigious journals easing rigid disciplinary boundaries.
Reinforcement learning (RL) can be used to learn treatment policies and aid decision making in healthcare. However, given the need for generalization over complex state/action spaces, the incorporation of function approximators (e.g., deep neural networks) requires model selection to reduce overfitting and improve policy performance at deployment. Yet a standard validation pipeline for model selection requires running a learned policy in the actual environment, which is often infeasible in a healthcare setting. In this work, we investigate a model selection pipeline for offline RL that relies on off-policy evaluation (OPE) as a proxy for validation performance. We present an in-depth analysis of popular OPE methods, highlighting the additional hyperparameters and computational requirements (fitting/inference of auxiliary models) when used to rank a set of candidate policies. We compare the utility of different OPE methods as part of the model selection pipeline in the context of learning to treat patients with sepsis. Among all the OPE methods we considered, fitted Q evaluation (FQE) consistently leads to the best validation ranking, but at a high computational cost. To balance thi
Objective: To (1) demonstrate the implementation of a data science platform built on open-source technology within a large, academic healthcare system and (2) describe two computational healthcare applications built on such a platform. Materials and Methods: A data science platform based on several open source technologies was deployed to support real-time, big data workloads. Data acquisition workflows for Apache Storm and NiFi were developed in Java and Python to capture patient monitoring and laboratory data for downstream analytics. Results: The use of emerging data management approaches along with open-source technologies such as Hadoop can be used to create integrated data lakes to store large, real-time data sets. This infrastructure also provides a robust analytics platform where healthcare and biomedical research data can be analyzed in near real-time for precision medicine and computational healthcare use cases. Discussion: The implementation and use of integrated data science platforms offer organizations the opportunity to combine traditional data sets, including data from the electronic health record, with emerging big data sources, such as continuous patient monitorin
Using the Scopus dataset (1996-2007) a grand matrix of aggregated journal-journal citations was constructed. This matrix can be compared in terms of the network structures with the matrix contained in the Journal Citation Reports (JCR) of the Institute of Scientific Information (ISI). Since the Scopus database contains a larger number of journals and covers also the humanities, one would expect richer maps. However, the matrix is in this case sparser than in the case of the ISI data. This is due to (i) the larger number of journals covered by Scopus and (ii) the historical record of citations older than ten years contained in the ISI database. When the data is highly structured, as in the case of large journals, the maps are comparable, although one may have to vary a threshold (because of the differences in densities). In the case of interdisciplinary journals and journals in the social sciences and humanities, the new database does not add a lot to what is possible with the ISI databases.
Due to rapidly rising healthcare costs worldwide, there is significant interest in controlling them. An important aspect concerns price transparency, as preliminary efforts have demonstrated that patients will shop for lower costs, driving efficiency. This requires the data to be made available, and models that can predict healthcare costs for a wide range of patient demographics and conditions. We present an approach to this problem by developing a predictive model using machine-learning techniques. We analyzed de-identified patient data from New York State SPARCS (statewide planning and research cooperative system), consisting of 2.3 million records in 2016. We built models to predict costs from patient diagnoses and demographics. We investigated two model classes consisting of sparse regression and decision trees. We obtained the best performance by using a decision tree with depth 10. We obtained an R-square value of 0.76 which is better than the values reported in the literature for similar problems.