Data breaches in healthcare continue to grow exponentially, calling for a rethinking into better approaches of security measures towards mitigating the menace. Traditional approaches including technological measures, have significantly contributed to mitigating data breaches but what is still lacking is the development of the "human firewall," which is the conscious care security practices of the insiders. As a result, the healthcare security practice analysis, modeling and incentivization project (HSPAMI) is geared towards analyzing healthcare staffs' security practices in various scenarios including big data. The intention is to determine the gap between staffs' security practices and required security practices for incentivization measures. To address the state-of-the art, a systematic review was conducted to pinpoint appropriate AI methods and data sources that can be used for effective studies. Out of about 130 articles, which were initially identified in the context of human-generated healthcare data for security measures in healthcare, 15 articles were found to meet the inclusion and exclusion criteria. A thorough assessment and analysis of the included article reveals that, KNN, Bayesian Network and Decision Trees (C4.5) algorithms were mostly applied on Electronic Health Records (EHR) Logs and Network logs with varying input features of healthcare staffs' security practices. What was found challenging is the performance scores of these algorithms which were not sufficiently outlined in the existing studies.
Background The time lag in detecting disease outbreaks remains a threat to global health security. The advancement of technology has made health-related data and other indicator activities easily accessible for syndromic surveillance of various datasets. At the heart of disease surveillance lies the clustering algorithm, which groups data with similar characteristics (spatial, temporal, or both) to uncover significant disease outbreak. Despite these developments, there is a lack of updated reviews of trends and modelling options in cluster detection algorithms. Objective Our purpose was to systematically review practically implemented disease surveillance clustering algorithms relating to temporal, spatial, and spatiotemporal clustering mechanisms for their usage and performance efficacies, and to develop an efficient cluster detection mechanism framework. Methods We conducted a systematic review exploring Google Scholar, ScienceDirect, PubMed, IEEE Xplore, ACM Digital Library, and Scopus. Between January and March 2018, we conducted the literature search for articles published to date in English in peer-reviewed journals. The main eligibility criteria were studies that (1) examined a practically implemented syndromic surveillance system with cluster detection mechanisms, including over-the-counter medication, school and work absenteeism, and disease surveillance relating to the presymptomatic stage; and (2) focused on surveillance of infectious diseases. We identified relevant articles using the title, keywords, and abstracts as a preliminary filter with the inclusion criteria, and then conducted a full-text review of the relevant articles. We then developed a framework for cluster detection mechanisms for various syndromic surveillance systems based on the review. Results The search identified a total of 5936 articles. Removal of duplicates resulted in 5839 articles. After an initial review of the titles, we excluded 4165 articles, with 1674 remaining. Reading of abstracts and keywords eliminated 1549 further records. An in-depth assessment of the remaining 125 articles resulted in a total of 27 articles for inclusion in the review. The result indicated that various clustering and aberration detection algorithms have been empirically implemented or assessed with real data and tested. Based on the findings of the review, we subsequently developed a framework to include data processing, clustering and aberration detection, visualization, and alerts and alarms. Conclusions The review identified various algorithms that have been practically implemented and tested. These results might foster the development of effective and efficient cluster detection mechanisms in empirical syndromic surveillance systems relating to a broad spectrum of space, time, or space-time.
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