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International System for Total Early Disease Detection (InSTEDD) Platform
                            Taha A. Kass-Hout, M.D., M.S., Nicolas di Tada
                                    InSTEDD, Palo Alto, California
                      OBJECTIVE                               tected in location X, and with a certain spatio-
This paper describes a hybrid (event-based and indi-          temporal pattern”). The human input and review
cator-based) surveillance platform designed to                module is exposed as a set of functionalities that al-
streamline the collaboration between domain experts           lows users to comment, tag, and rank the elements
and machine learning algorithms for detection, pre-           (positive, neutral, or negative). Additionally, users
diction and response to health-related events (such as        can generate and test multiple hypotheses in parallel,
disease outbreaks).                                           further collect and rank sets of related items (evi-
                                                              dence), and model against baseline information (for
                    BACKGROUND
                                                              cyclical or known events). The platform maintains a
Over the last decade, the majority of the designs,            list of ongoing possible threats allowing domain ex-
analyses and evaluations of early detection [1] (or           perts to focus their field information and either con-
biosurveillance) systems have been geared towards             firm or reject the hypotheses created. That feedback
specific data sources and detection algorithms. Much          is then fed into the system to update (increase or de-
less effort has been focused on how these systems             crease) the reliability of the sources and credibility of
will "interact" with humans [2]. For example, con-            the users in light of their inferences or decisions.
sider multiple domain experts working at different
                                                                                      RESULTS
levels across different organizations in an environ-
ment where numerous biosurveillance algorithms                The platform synthesizes health-related event indica-
may provide contradictory interpretations of ongoing          tors from a wide variety of information sources
events. This paper discusses the anticipated contribu-        (structured and unstructured) into a consolidated pic-
tion of social networking, machine learning and col-          ture for analysis, maintenance of “community-wide
laboration techniques to address these emerging is-           coherence” [3], and collaboration processes. This
sues by drawing upon methods, models and tech-                helps detect anomalies, visualize clusters of potential
nologies that have been proven to work in other chal-         events, predict the rate and spread of a disease out-
lenging domains.                                              break and provide decision makers with tools, meth-
                                                              odologies and processes to investigate the event.
                       METHODS
                                                              Presently, the platform and associated modules are
The platform consists of several high-level modules,          being piloted for the Mekong Basin region in SE
including: 1) Data gathering, 2) Automatic feature            Asia.
extraction, data classification and tagging, 3) Human
                                                                                   CONCLUSIONS
input, hypotheses generation and review, 4) Predic-
tions and alerts output, and 5) Field confirmation and        In this paper we describe a platform that enables de-
feedback. The data gathering module allows users              tection, prediction and response to health-related
to collect information from several sources (SMS              events through a collaborative approach that com-
messages, RSS feeds, email list (e.g., ProMed),               bines data exploration, integration, search and infer-
documents, web pages, electronic medical records,             encing – providing more complex analysis and
animal disease data, environmental feed, remote               deeper insight. We believe that such a platform repre-
sensing, etc.). The automatic feature extraction,             sents the next generation of early detection and re-
data classification and tagging module is an exten-           sponse systems.
sible architecture that allows the introduction of ma-                              REFERENCES
chine learning algorithms (e.g., Bayesian). These             [1] Ping Yan, Daniel Dajun Zeng, Hsinchun Chen: A Review of
components extract and augment the features (or               Public Health Syndromic Surveillance Systems. ISI 2006; 249-
metadata) from multiple data streams; such as: source         260.
and target geo-location, time, route of transmission          [2] Thagard, P. Coherence, truth, and the development of scientific
(e.g., person-to-person, waterborne), etc. In addition,       knowledge. Philosophy of Science 2007;74, 28-47.
these components help detect relationships between            [3] Billman, D., Convertino, G. Shrager, J. Massar, JP. and Pirolli
these extracted features within a collaborative space         P. The CACHE Study: Supporting Collaborative Intelligence.
or across different collaborative spaces. Furthermore,        Paper presented at the HCIC 2006 Winter Workshop on Collabora-
                                                              tion, Cooperation, Coordination. Feb. 2006.
with human input, these components can suggest
possible events or event types (e.g., at the earliest         Further Information:
stages of a disease outbreak: “there is an unknown            Taha Kass-Hout, kasshout@instedd.org
respiratory event, transmitted person-to-person, de-          http://www.instedd.org




                                                          Advances in Disease Surveillance 2008;5:108

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International system for total early disease detection (INSTEDD) platform

  • 1. International System for Total Early Disease Detection (InSTEDD) Platform Taha A. Kass-Hout, M.D., M.S., Nicolas di Tada InSTEDD, Palo Alto, California OBJECTIVE tected in location X, and with a certain spatio- This paper describes a hybrid (event-based and indi- temporal pattern”). The human input and review cator-based) surveillance platform designed to module is exposed as a set of functionalities that al- streamline the collaboration between domain experts lows users to comment, tag, and rank the elements and machine learning algorithms for detection, pre- (positive, neutral, or negative). Additionally, users diction and response to health-related events (such as can generate and test multiple hypotheses in parallel, disease outbreaks). further collect and rank sets of related items (evi- dence), and model against baseline information (for BACKGROUND cyclical or known events). The platform maintains a Over the last decade, the majority of the designs, list of ongoing possible threats allowing domain ex- analyses and evaluations of early detection [1] (or perts to focus their field information and either con- biosurveillance) systems have been geared towards firm or reject the hypotheses created. That feedback specific data sources and detection algorithms. Much is then fed into the system to update (increase or de- less effort has been focused on how these systems crease) the reliability of the sources and credibility of will "interact" with humans [2]. For example, con- the users in light of their inferences or decisions. sider multiple domain experts working at different RESULTS levels across different organizations in an environ- ment where numerous biosurveillance algorithms The platform synthesizes health-related event indica- may provide contradictory interpretations of ongoing tors from a wide variety of information sources events. This paper discusses the anticipated contribu- (structured and unstructured) into a consolidated pic- tion of social networking, machine learning and col- ture for analysis, maintenance of “community-wide laboration techniques to address these emerging is- coherence” [3], and collaboration processes. This sues by drawing upon methods, models and tech- helps detect anomalies, visualize clusters of potential nologies that have been proven to work in other chal- events, predict the rate and spread of a disease out- lenging domains. break and provide decision makers with tools, meth- odologies and processes to investigate the event. METHODS Presently, the platform and associated modules are The platform consists of several high-level modules, being piloted for the Mekong Basin region in SE including: 1) Data gathering, 2) Automatic feature Asia. extraction, data classification and tagging, 3) Human CONCLUSIONS input, hypotheses generation and review, 4) Predic- tions and alerts output, and 5) Field confirmation and In this paper we describe a platform that enables de- feedback. The data gathering module allows users tection, prediction and response to health-related to collect information from several sources (SMS events through a collaborative approach that com- messages, RSS feeds, email list (e.g., ProMed), bines data exploration, integration, search and infer- documents, web pages, electronic medical records, encing – providing more complex analysis and animal disease data, environmental feed, remote deeper insight. We believe that such a platform repre- sensing, etc.). The automatic feature extraction, sents the next generation of early detection and re- data classification and tagging module is an exten- sponse systems. sible architecture that allows the introduction of ma- REFERENCES chine learning algorithms (e.g., Bayesian). These [1] Ping Yan, Daniel Dajun Zeng, Hsinchun Chen: A Review of components extract and augment the features (or Public Health Syndromic Surveillance Systems. ISI 2006; 249- metadata) from multiple data streams; such as: source 260. and target geo-location, time, route of transmission [2] Thagard, P. Coherence, truth, and the development of scientific (e.g., person-to-person, waterborne), etc. In addition, knowledge. Philosophy of Science 2007;74, 28-47. these components help detect relationships between [3] Billman, D., Convertino, G. Shrager, J. Massar, JP. and Pirolli these extracted features within a collaborative space P. The CACHE Study: Supporting Collaborative Intelligence. or across different collaborative spaces. Furthermore, Paper presented at the HCIC 2006 Winter Workshop on Collabora- tion, Cooperation, Coordination. Feb. 2006. with human input, these components can suggest possible events or event types (e.g., at the earliest Further Information: stages of a disease outbreak: “there is an unknown Taha Kass-Hout, kasshout@instedd.org respiratory event, transmitted person-to-person, de- http://www.instedd.org Advances in Disease Surveillance 2008;5:108