M M Wagner

University of Pittsburgh, Pittsburgh, Pennsylvania, United States

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Publications (26)4.74 Total impact

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    ABSTRACT: The Apollo Structured Vocabulary (Apollo-SV) is a Web Ontology Language 2 (OWL 2) representation of terms related to epidemic simulation. We are developing Apollo-SV by ontological analysis of the information used and created by epidemic simulators and the entities this information is about. A key finding of our analysis is that the input of an epidemic simulator is properly understood as (1) a representation of an ecosystem at simulator time zero, (2) information about infectious diseases of interest in the ecosystem, and (3) information about plans to control the diseases. This insight is reflected in the scope of Apollo-SV, which includes terms from the domains of both infectious disease epidemiology and population biology. We also found that some definitions in the Infectious Disease Ontology (IDO), including 'infection', 'infection acquisition', 'infectious disease', 'pathogen', and 'host', were not compatible with the meanings of the terms as used in epidemic simulation; thus, we created new definitions of these terms. Our analysis of epidemic simulators-which are mathematical models of phenomena studied by infectious disease epidemiology-afforded several advantages that likely explain why we discovered limitations of IDO. As a result, we recommend that development of biomedical ontologies intended for reuse consider the perspective of the overlapping biological science(s) involved. Apollo-SV is freely available at: http://purl.obolibrary.org/obo/apollo-sv.owl.
    No preview · Article · Jan 2014
  • Ron M. Aryel · Michael M. Wagner

    No preview · Article · Jan 2006
  • W.R. Hogan · M.M. Wagner

    No preview · Chapter · Jan 2006
  • M.M. Wagner · W.R. Hogan · R.M. Aryel

    No preview · Article · Jan 2006
  • Ron M. Aryel · Michael M. Wagner

    No preview · Chapter · Jan 2006
  • Garrick L Wallstrom · Wagner MM · Hogan WR
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    ABSTRACT: When public health surveillance systems are evaluated, CDC recommends that the expected sensitivity, specificity, and timeliness of surveillance systems be characterized for outbreaks of different sizes, etiologies, and geographic or demographic scopes. High-Fidelity Injection Detectability Experiments (HiFIDE) is a tool that health departments can use to compute these metrics for detection algorithms and surveillance data that they are using in their surveillance system. The objective of this study is to develop a tool that allows health departments to estimate the expected sensitivity, specificity, and timeliness of outbreak detection. HiFIDE extends existing semisynthetic injection methods by replacing geometrically shaped injects with injects derived from surveillance data collected during real outbreaks. These injects maintain the known relation between outbreak size and effect on surveillance data, which allows inferences to be made regarding the smallest outbreak that can be expected to be detectable. An example illustrates the use of HiFIDE to analyze detectability of a waterborne Cryptosporidium outbreak in Washington, DC. HiFIDE enables public health departments to perform system validations recommended by CDC. HiFIDE can be obtained for no charge for noncommercial use (http://www.hifide.org).
    No preview · Article · Sep 2005 · MMWR. Morbidity and mortality weekly report
  • Jeremy U Espino · M. M. Wagner · C Szczepaniak · F C Tsui · H Su · R Olszewski · Z Liu · W Chapman · X Zeng · L Ma · Z Lu · J Dara
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    ABSTRACT: Computer-based outbreak and disease surveillance requires high-quality software that is well-supported and affordable. Developing software in an open-source framework, which entails free distribution and use of software and continuous, community-based software development, can produce software with such characteristics, and can do so rapidly. The objective of the Real-Time Outbreak and Disease Surveillance (RODS) Open Source Project is to accelerate the deployment of computer-based outbreak and disease surveillance systems by writing software and catalyzing the formation of a community of users, developers, consultants, and scientists who support its use. The University of Pittsburgh seeded the Open Source Project by releasing the RODS software under the GNU General Public License. An infrastructure was created, consisting of a website, mailing lists for developers and users, designated software developers, and shared code-development tools. These resources are intended to encourage growth of the Open Source Project community. Progress is measured by assessing website usage, number of software downloads, number of inquiries, number of system deployments, and number of new features or modules added to the code base. During September--November 2003, users generated 5,370 page views of the project website, 59 software downloads, 20 inquiries, one new deployment, and addition of four features. Thus far, health departments and companies have been more interested in using the software as is than in customizing or developing new features. The RODS laboratory anticipates that after initial installation has been completed, health departments and companies will begin to customize the software and contribute their enhancements to the public code base.
    No preview · Article · Oct 2004 · MMWR. Morbidity and mortality weekly report
  • Wagner MM · Espino JU · Tsui F-C · Aryel RM

    No preview · Chapter · May 2004
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    F C Tsui · M M Wagner · V. M. Dato · C. C. H. Chang
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    ABSTRACT: To assess the value of ICD-9-coded chief complaints for early detection of epidemics, we measured sensitivity, positive predictive value, and timeliness of Influenza detection using a respiratory set (RS) of ICD-9 codes and an Influenza set (IS). We also measured inherent timeliness of these data using the cross-correlation function. We found that, for a one-year period, the detectors had sensitivity of 100% (1/1 epidemic) and positive predictive values of 50% (1/2) for RS and 25% (1/4) for IS. The timeliness of detection using ICD-9-coded chief complaints was one week earlier than the detection using Pneumonia and Influenza deaths (the gold standard). The inherent timeliness of ICD-9 data measured by the cross-correlation function was two weeks earlier than the gold standard.
    Full-text · Article · Feb 2001 · Proceedings / AMIA ... Annual Symposium. AMIA Symposium
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    J U Espino · M M Wagner
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    ABSTRACT: ICD-9-coded chief complaints and diagnoses are a routinely collected source of data with potential for use in public health surveillance. We constructed two detectors of acute respiratory illness: one based on ICD-9-coded chief complaints and one based on ICD-9-coded diagnoses. We measured the classification performance of these detectors against the human classification of cases based on review of emergency department reports. Using ICD-9-coded chief complaints, the sensitivity of detection of acute respiratory illness was 0.44 and its specificity was 0.97. The sensitivity and specificity using ICD-9-coded diagnoses were no different. These properties of excellent specificity and moderate sensitivity, coupled with the earliness and electronic availability of such data, support the use of detectors based on ICD-9 coding of emergency department chief complaints in public health surveillance.
    Preview · Article · Feb 2001 · Proceedings / AMIA ... Annual Symposium. AMIA Symposium
  • J. U. Espino · M. M. Wagner

    No preview · Article · Jan 2001
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    W R Hogan · M M Wagner
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    ABSTRACT: Clinical event monitors (CEMs) seek to improve patient care and reduce its cost by prompting clinicians to take actions that have these effects. To persuade clinicians to act, CEMs have used prewritten-text explanations. However, we encountered limitations of prewritten-text explanations in our CEM. Therefore, we decided to implement an advanced method for explanation (Suermondt's method for belief-network explanation). This method is promising, but whether it is generally applicable to all of clinical event monitoring and whether it is as efficacious as prewritten-text explanations remain areas for future research.
    Full-text · Article · Feb 1999 · Proceedings / AMIA ... Annual Symposium. AMIA Symposium
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    M M Wagner · F C Tsui · J Pike · L Pike
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    ABSTRACT: We describe the requirements and design of an enterprise-wide notification system. From published descriptions of notification schemes, our own experience, and use cases provided by diverse users in our institution, we developed a set of functional requirements. The resulting design supports multiple communication channels, third party mappings (algorithms) from message to recipient and/or channel of delivery, and escalation algorithms. A requirement for multiple message formats is addressed by a document specification. We implemented this system in Java as a CORBA object. This paper describes the design and current implementation of our notification system.
    Full-text · Article · Feb 1999 · Proceedings / AMIA ... Annual Symposium. AMIA Symposium
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    F C Tsui · M M Wagner · W Wilbright · A Tse · W R Hogan
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    ABSTRACT: We developed and evaluated a feature that allows users to control what types of clinical information are delivered to them. Using a paper or web-based configuration form, users turn individual alerts and sets of results on or off, and set how they are delivered. We used usage rates to evaluate this feature. Of 16 residents who had received clinical information from our clinical event monitor, 4 (25%) made at least one change (range 10-25). Of 41 interns, 5 (12.2%) made at least one change (range 5-91). The difference was borderline significant (p < 0.1). 5/7 web users changed preferences through a dial-up connection from home. More users used the web-based preference form than the paper form. This difference may be due to the better accessibility of the web-based form. A survey established that this feature was not as highly utilized as anticipated partly because the initial (default) preference setting was acceptable and partly because the users were too busy to customize their alert settings. We conclude that user configuration of a system that delivers information using a web-based preference form is feasible and may become important as the volume of information and number of available communication channels increase.
    Full-text · Article · Jan 1999 · Proceedings / AMIA ... Annual Symposium. AMIA Symposium
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    ABSTRACT: The ability to have access to information relevant to patient care is essential within the healthcare environment. To meet the information needs of its workers, healthcare information systems must fulfill a variety of functional requirements. One of these requirements is to define how workers will interact with the system to gain the information they need. Currently, most healthcare information systems rely on users querying the system via a fixed terminal for the information they desire; a method that is inefficient because there is no guarantee the information will be available at the time of their query and it interrupts their work flow. In general, clinical event monitors--systems whose efficacy relies on the delivery of time-critical information--have used e-mail and numeric pagers as their methods to deliver information. Each of these methods, however, still requires the user to perform additional steps, i.e., log into an information system in order to attain the information about which the system is alerting them. In this paper we describe the integration and use of 2-way alphanumeric pagers in CLEM, the UPMC Health System's Clinical Event Monitor, and how the use of these pagers addresses the information needs of mobile workers in healthcare.
    Full-text · Article · Feb 1998 · Proceedings / AMIA ... Annual Symposium. AMIA Symposium
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    M M Wagner · SA Eisenstadt · W R Hogan · M C Pankaskie
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    ABSTRACT: We elicited from medical house staff their preferences for e-mail and alphanumeric pager as communication channels for the delivery of 18 different types of clinical information about their inpatients. For each type, we calculated the proportion of users who preferred delivery by e-mail, pager, both, or neither (usual delivery). For 14/18 (78%) types, more users preferred delivery by pager than by the other options. For 2/18 (11%) types, e-mail was preferred. For 2/18 (11%) types, more users preferred redundant delivery using both channels. For no types did more users prefer neither, meaning that the information would be delivered by traditional channels, if any. We conclude that medical house staff in the inpatient setting prefer to receive many types of clinical information by pager. The reason may be that they otherwise would have to query clinical information systems for these data, which is wasteful of their time and introduces delays into the process of care. Additionally, we found significant inter-user variability, suggesting that it may be useful for the notification services of an enterprise to employ user profiles for the delivery of clinical information.
    Full-text · Article · Feb 1998 · Proceedings / AMIA ... Annual Symposium. AMIA Symposium
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    W R Hogan · M M Wagner
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    ABSTRACT: We argue that the optimal use of communication channels in clinical event monitors is an important design consideration for these systems. We review the state-of-the-art in selection of communication channels, including our current approach--allowing users to choose the communication channel by which the event monitor sends each notification. We describe a new approach that we are in the process of developing. In this new approach, we view event monitoring as the decision of whether and how to send new patient data to a clinician and apply the principle of maximum expected utility to this decision problem. Our initial experience with this approach suggests that notifying clinicians of normal patient data may be of high utility. We also found that methods for explanation in uncertain reasoning may be necessary in this approach.
    Full-text · Article · Feb 1998 · Proceedings / AMIA ... Annual Symposium. AMIA Symposium
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    ABSTRACT: The utilization of the appropriate level of temporal abstraction is an important aspect of time modeling. We discuss some aspects of the relation of temporal abstraction to important knowledge engineering parameters such as model correctness, ease of model specification, knowledge availability, query completeness, inference tractability, and semantic clarity. We propose that versatile and efficient time-modeling formalisms should encompass ways to represent and reason at more than one level of abstraction, and we discuss such a hybrid formalism. Although many research efforts have concentrated on the automation of specific temporal abstractions, much research needs to be done in understanding and developing provably optimal abstractions. We provide an initial framework for studying this problem in a manner that is independent of the particular problem domain and knowledge representation, and suggest several research challenges that appear worth pursuing.
    Full-text · Article · Oct 1997 · Computers in Biology and Medicine
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    ABSTRACT: Although the literature on event monitoring is extensive, it does not cover all issues that we encountered while developing an event monitor at our institution. We had to resolve issues related to event detection, scalability, what topics were suitable for asynchronous decision support, and overlap of efforts of other groups at the institution attempting to improve quality and lower cost of care. In this paper, we describe our experience deploying CLEM, the clinical event monitor at the University of Pittsburgh with emphasis on these topics.
    Full-text · Article · Feb 1997 · Proceedings: a conference of the American Medical Informatics Association / ... AMIA Annual Fall Symposium. AMIA Fall Symposium
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    M C Pankaskie · M M Wagner
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    ABSTRACT: We developed a clinical event monitor that is currently deployed in an inpatient setting. We selected CLIPS as the basis for its KB and inference engine. This paper describes the considerations that went into that decision, how we represented drug and laboratory knowledge in CLIPSs, and how we extended CLIPS to deal with temporal inferences. We also review the published literature about the use of CLIPS in medicine.
    Preview · Article · Feb 1997 · Proceedings: a conference of the American Medical Informatics Association / ... AMIA Annual Fall Symposium. AMIA Fall Symposium