Jean-François Ethier

GRIIS.ca || Université de Sherbrooke || INSERM · Medicine

Background. A large volume of heavily fragmented data is generated daily in different healthcare contexts and is stored using various structures with different semantics. This fragmentation and heterogeneity make secondary use of data a challenge. Data integration approaches that derive a common data model from sources or requirements have some adv...

The notion of affordance remains elusive, notwithstanding its importance for the representation of agency, cognition, and behaviors. This paper lays down a foundation for an ontology of affordances by elaborating the idea of “core affordance” which would serve as a common ground for explaining existing diverse conceptions of affordances and their i...

Background Social inequalities in complications associated with diabetes mellitus persist. As a primary care sensitive condition (PCSC), this association could be related to differential access to primary care. Our objectives are to establish a typology of care trajectories following a new diagnosis, and to explore social determinants of trajectori...

Objective: Assess adherence to the Diabetes Clinical Practice Guidelines (CPG) for the Prevention and Treatment of Cardiovascular Disease (CVD) in Family Medicine Groups (FMG) in Quebec. Methodology: A retrospective cohort was used with patients with diabetes (PWD) and/or CVD, enrolled in a FMG and the Public Prescription Drug Plan (PPDP) between 2...

Realizable entities are properties that can be realized in processes of specific correlated types in which the bearer participates. It will be valuable to create a systematic classification of realizable entities because they are useful for various modeling purposes in ontologies. In this paper we outline a unifying framework for realizable entitie...

While drugs and related products have profoundly changed the lives of people around the world, ongoing challenges remain, including inappropriate use of a drug product. Inappropriate uses can be explained in part by ambiguous or incomplete information, for example, missing reasons for treatments, ambiguous information on how to take a medication, o...

Objective The study sought to evaluate the expected clinical utility of automatable prediction models for increasing goals-of-care discussions (GOCDs) among hospitalized patients at the end of life (EOL). Materials and Methods We built a decision model from the perspective of clinicians who aim to increase GOCDs at the EOL using an automated alert...

Background The advent of learning healthcare systems (LHSs) raises an important implementation challenge concerning how to request and manage consent to support secondary use of data in learning cycles, particularly research activities. Current consent models in Quebec were not established with the context of LHSs in mind and do not support the agi...

Objective To evaluate the clinical utility of automatable prediction models for increasing goals-of-care discussions among hospitalized patients at the end-of-life. Materials and Methods We developed three Random Forest (RF) models and updated the Modified Hospital One-year Mortality Risk model: alternative models to predict one-year mortality (pro...

A survey was conducted to assess citizens, research ethics committee members, and researchers’ attitude toward information and consent for the secondary use of health data for research within learning health systems (LHSs). Results show that the reuse of health data for research to advance knowledge and improve care is valued by all parties; consen...

Given the ever-growing body of knowledge, healthcare improvement hinges more than ever on efficient knowledge transfer to clinicians and patients. Promoted initially by the Institute of Medicine, the Learning Health System (LHS) framework emerged in the early 2000s. It places focus on learning cycles where care delivery is tightly coupled with rese...

A provincial survey was conducted to assess citizens, research ethics committee (REC) members and researchers’ attitude toward information and consent for the secondary use of health data for research within a learning health system (LHS). The results show that: 1) reuse of health data for research to advance knowledge and improve care is values by...

A provincial survey was conducted to assess citizens, research ethics committee (REC) members and researchers’ attitude toward information and consent for the secondary use of health data for research within a learning health system (LHS). The results show that: 1) reuse of health data for research to advance knowledge and improve care is values by...

Background: The advent of learning healthcare systems (LHSs) raises an important implementation challenge concerning how to request and manage consent to support secondary use of data in learning cycles, particularly research activities. Current consent models in Quebec were not established with the context of LHSs in mind and do not support the ag...

Administrative health data is recognized for its value for conducting population-based research that has contributed to numerous improvements in health. In Canada, each province and territory is responsible for administering its own publicly funded health care program, which has resulted in multiple sets of administrative health data. Challenges to...

This article provides the basis of a formal axiomatic system for a mereology of informational entities based on the idea of information fillers that can occupy information slots, such as the same word that can be used in different sentences. It is inspired by Karen Bennett’s mereological system that enables a whole to have a part “twice over”, but...

Introduction: A major consideration for the implementation of a learning health system (LHS) is consent from participants to the use of their data for research purposes. The main objective of this paper was to identify in the literature which types of consent have been proposed for participation in research observational activities in a LHS. We we...

Purpose Potentially inappropriate medications (PIMs) have been associated with a greater risk of adverse drug events and hospitalizations. To reduce PIMs use, a family health team (FHT) implemented a knowledge translation (KT) strategy that included a pharmacist-physician intervention model based on alerts from a computerized alert system (CAS). M...

The ambiguities and overspecificities of prescription semantics along with their lack of standardization hinders the adoption of electronic prescriptions in some countries, limit data interoperability and are potential sources of error. An ontology of drug prescriptions could help overcome such difficulties and ultimately reduce adverse drug events...

A huge amount of data is being generated every day from different sources. Access to these data can be very valuable for decision-making. Nevertheless, the extraction of information of interest remains a major challenge given a large number of heterogeneous databases. Building shareable and (re)usable data access mechanisms including automated veri...

Objectives: To synthesize concepts and approaches related to the analysis of patterns or processes of care and patient's outcomes into a comprehensive model of care trajectories, focusing on hospital readmissions for patients with chronic ambulatory care sensitive conditions (ACSCs). Study design: Narrative literature review. Methods: Publishe...

An analysis based on referent tracking systems shows that a classical medical application of bitemporalized relational database that uses classes as attribute values is ambiguous in several respects. This suggests that to avoid such ambiguities, bitemporalized relational databases could be structured on the basis of ontological representations that...

Purpose: The use of potentially inappropriate medications (PIMs) in hospitalized older adults is a complex problem, but the use of computerized alert systems (CAS) has shown some potential. The study's objective is to assess the change in PIM use with a CAS-based pharmacist-physician intervention model compared to usual clinical care. Methods: P...

Introduction: The current model of medical knowledge production, transfer, and application suffers from serious shortcomings. Learning health systems (LHS) have recently emerged as a potential solution-systems in which health information generated from patients is continuously analyzed to improve knowledge that will be transferred to patient care....

Traditional data warehouse design methods do not fully address some important challenges, particularly temporal ones. Among them past indeterminacy is not handled systematically and uniformly. Furthermore, most methods published until now present transformation approaches by providing examples rather than general and systematic transformation rules...

Objective The Learning Health System (LHS) requires integration of research into routine practice. ‘eSource’ or embedding clinical trial functionalities into routine electronic health record (EHR) systems has long been put forward as a solution to the rising costs of research. We aimed to create and validate an eSource solution that would be readil...

Background Biomedical ontologies aim at providing the most exhaustive and rigorous representation of reality as described by biomedical sciences. A large part of medical reasoning deals with diagnosis and is essentially probabilistic. It would be an asset for biomedical ontologies to be able to support such a probabilistic reasoning and formalize B...

Medical terminology mapping has been widely recognised as a complex yet critical prerequisite for querying and integrating patient data from heterogeneous data sources. Several studies have tried to address this issue but only a few systems have successfully implemented mappings from multiple medical terminologies. While these systems typically pro...

Motivation: Medical terminology mapping is a long-standing challenge for projects requiring retrieval, querying and integration of heterogeneous patient data. Current tools fail to fully utilise the richness of the underlying coding systems, and can be difficult to install and maintain. For example, National Library of Medicine’s UMLS provides a ri...

Objectives: To evaluate the effect of a knowledge translation (KT) strategy to reduce potentially inappropriate medication (PIM) use in elderly inpatients in the hospital. Design: Segmented regression analysis of an interrupted time series. Setting: Teaching hospital. Participants: Individuals aged 75 and older discharged from the hospital i...

Electronic prescriptions are supported as a means to reduce adverse drug events, but the ambiguities and overspecificities of prescription semantics along with their lack of standardization reduce adoption, limit interoperability and are potential sources of error. Ontologies in the OBO Foundry, founded on realist methodology, have been successful...

Génération automatisée de schémas relationnels intemporels dans un contexte d’entrepôt de données

Unlabelled: The Learning Health System (LHS) describes linking routine healthcare systems directly with both research translation and knowledge translation as an extension of the evidence-based medicine paradigm, taking advantage of the ubiquitous use of electronic health record (EHR) systems. TRANSFoRm is an EU FP7 project that seeks to develop a...

In secondary data use context, traditional data warehouse design methods don’t address many of today’s challenges; particularly in the healthcare domain were semantics plays an essential role to achieve an effective and implementable heterogeneous data integration while satisfying core requirements. Forty papers were selected based on seven core re...

Architecture et méthode de construction d’entrepôts de données au coeur des systèmes informationnels régionaux de santé.

Evidence-based practice has become the cornerstone of high quality clinical care. However, producing evidence of sufficient quantity and quality is hampered by the high cost and complexity of conducting research, the numbers of clinicians and patients willing to participate in clinical trials. The Learning Healthcare System initiative creates route...

This article presents CVDO, an ontology of cardiovascular diseases structured on OBO foundry's principle and based on BFO and FMA. CVDO reorganizes and completes DOID cardiovascular diseases around OGMS tripartite model of disease, and builds its taxonomy of diseases largely by automatic reasoning. It points to the need of OGMS to be supplemented b...

Routinely collected clinical data can be reused in a number of research tasks, including cohort identification and pre-population of electronic case report forms. TRANSFoRm adopts a model-based, mediation approach to address the data integration challenges of such reuse and bridge the semantic gap between clinical and research domains.

Introduction: This article is part of the Focus Theme of METHODS of Information in Medicine on "Managing Interoperability and Complexity in Health Systems". Background: Primary care data is the single richest source of routine health care data. However its use, both in research and clinical work, often requires data from multiple clinical sites,...

The reuse of routinely collected clinical data for clinical research is being explored as part of the drive to reduce duplicate data entry and to start making full use of the big data potential in the healthcare domain. Clinical researchers often need to extract data from patient registries and other patient record datasets for data analysis as par...

The reuse of routinely collected clinical data for clinical research is being explored as part of the drive to reduce duplicate data entry and to start making full use of the big data potential in the healthcare domain. Clinical researchers often need to extract data from patient registries and other patient record datasets for data analysis as par...

The Learning Healthcare System (LHCS) refers to the close coupling of practice of clinical medicine with both the conduct of research and the translation of research into practice. This panel presents an outline of the TRANSFoRm project (www.transformproject.eu), a large EU FP7 Integrated Project to develop a digital infrastructure for the LHCS in...

Background: Without robust clinical evidence to guide titration of vasopressors in septic shock, it is unclear how dosing of these potent medications occurs. We sought to measure the proportion of vasopressor prescriptions for septic shock that were missing explicit targets and to describe the targets that we identified. Methods: We conducted a...

Objective Biomedical research increasingly relies on the integration of information from multiple heterogeneous data sources. Despite the fact that structural and terminological aspects of interoperability are interdependent and rely on a common set of requirements, current efforts typically address them in isolation. We propose a unified ontology-...

Identifying and recruiting eligible research participants for studies is an expensive process, especially when involving heterogeneous, multinational electronic data sources. To support this, we developed a provenance-aware query formulation tool that researchers can use to collaboratively define protocols; and trace back protocol development and p...