Portinari: A Data Exploration Tool to Personalize Cervical Cancer Screening
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1 Portinari: A Data Exploration Tool to Personalize Cervical Cancer Screening Sagar Sen, Manoel Horta Ribeiro, Raquel C. de Melo Minardi, Wagner Meira Jr., Mari Nygård Certus V&V Center and HPV Research Group, Department of Computer Science, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil, HPV Research Group, Cancer Registry of Norway, Oslo, Norway 1
2 Software s Impact in Societal Processes Through which means societies organize themselves? 2
3 Software s Impact in Societal Processes Through which means societies organize themselves? politics 2
4 Software s Impact in Societal Processes Through which means societies organize themselves? politics 2
5 Software s Impact in Societal Processes Through which means societies organize themselves? politics social bonds 2
6 Software s Impact in Societal Processes Through which means societies organize themselves? politics social bonds 2
7 Software s Impact in Societal Processes Through which means societies organize themselves? politics social bonds labour 2
8 Software s Impact in Societal Processes Through which means societies organize themselves? politics social bonds labour 2
9 Self-organizing vs. Centralized 3
10 Self-organizing vs. Centralized 3
11 Self-organizing vs. Centralized vs 3
12 Self-organizing vs. Centralized vs 3
13 4
14 Norway s Screening Program AGUS/ASC-H/HSIL/ACIS/Ca Immediately Colposcopy with biopsy Entry intro screening program years of age Unsatisfactory 1-3 months Cytology Normal 3 years Cytology ASC-US/LSIL Immediately HPV Normal 3 years HPV-test HPV +ve 6-12 months HPV Normal and Cytology Normal/ASC-US 3 years HPV +ve Immediately New Cytology and HPVtest HPV Normal and LSIL or LSIL/AGUS/ ASC-H/ACIS/Ca Immediately Definitions ACIS: Adenocarcinoma in situ AGUS: Atypical glandular cells of undetermined significance, under cell. ASC-H: Irregular squamous cells with changes suggestive of high grade lesion, but do not meet all the criteria for diagnosis ASC-US: Irregular squamous cells with abnormalities of uncertain significance Ca: All types of cancer Cytology: Test to look at abnormal cells HPV: Humanpapillomavirus HSIL: High-grade squamous intraepithelial lesion LSIL: Low-grade squamous intraepithelial lesion 5
15 Triage Algorithm Invitation and Reminders Screening Exams 6
16 Triage Algorithm Invitation and Reminders Screening Exams 6
17 Verification and Validation Triage Algorithm Invitation and Reminders Screening Exams 6
18 Verification and Validation Triage Algorithm Invitation and Reminders Screening Exams 6
19 Verification and Validation Triage Algorithm Invitation and Reminders Screening Exams Statistics by epidemiologists 6
20 Verification and Validation Triage Algorithm Invitation and Reminders Screening Exams Statistics by epidemiologists Data exploration and visualization 6
21 7
22 What data? 8
23 9
24 What representation? 10
25 Querying 11
26 12
27 Portinari Flow Diagrams of Future Paths The flow diagram starts where the query patterns ends, showing Portinari allows two charts to be displayed side by side! Hovering over the edges or nodes of the graph shows stats! Each layer represents the distribution of diagnosis n exams into the future. 13
28 Explorations 14
29 Exploring effects of screening guidelines 3-4 years Cytology Normal Cytology Normal What happens after 3 years to this cohort? 15
30 Next Diagnosis in 3 years individuals 230,331 individuals 39 individuals 16
31 Next Two Diagnoses individuals individuals Did not return 17
32 Exploring existing screening guidelines 3-4 years Cytology Normal Cytology Normal What if women come back in the next 30 days? 18
33 4337 individuals Cytology not good enough for some? 19
34 Comparing two scenarios in the triage algorithm next exam Cytology Normal HPV +ve Come back within 1 year (Guideline) vs. Come back in 1 to 2 years 20
35 Returned within 1 year Returned in 1-2 years individuals 278 individuals (227) 1.61% HPV +ve (19) 6.83% HPV +ve 21
36 Conclusion Alternative way of verifying and validating paths taken by people in a socio-technical system. Use of easy-to-query graph database. Generalizable to event-driven data. Generation hypothesis for further statistical investigation. 22
37 Questions? Manoel Horta Ribeiro manoelribeiro homepages.dcc.ufmg.br/~manoelribeiro/ 23
38 Questions? Manoel Horta Ribeiro manoelribeiro homepages.dcc.ufmg.br/~manoelribeiro/ 23
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