1 Digital Libraries and Evidence in the Developing World Context Dr. Jon Ferguson Senior Health Database Scientist IMMPACT Project University of Aberdeen

2 Why IMMPACT? Initiative for Maternal Mortality Programme Assessment Provide evidence of the effectiveness and cost-effectiveness of Public Health interventions in reducing MM Capture and disseminate evidence via an ‘Evidence Database’ Strengthen developing country partners’ capacity

3 Why IMMPACT? 98.2% of all Maternal Deaths occur in developing nations In the last 70 years Maternal Mortality Rate (MMR) has dropped by 80% in developing countries such as Scotland 1990 Millenium Development goal: 75% reduction in MMR by 2015 Reduction in MMR not on target, why?

4 Why IMMPACT? MMR is driven by a system of interacting causes – complex interventions are needed Primary outcomes such as MMR are hard to measure Policy decisions are not always based on evidence.

5 An Opportunity The Health Information Review –“Universal access to essential healthcare information by 2015” IMMPACT –International collaboration with currently 3 developing countries: Burkina Faso, Indonesia, Ghana Recent advances in Digital Libraries, Information Extraction and the Semantic Web

6 What Evidence? IMMPACT Evidence Base using DSPACE, local dedicated servers research question: how can causal modelling contribute to output interfaces? research question: how can causal modelling contribute to output interfaces? www and grey literature existing data e.g. PubMed local document collections other existing information evaluation results evaluation design output via policy- makers’ interface output via researchers’ interface global dissemination research question: what are innovative ways of extracting information from disparate, random sources research question: what are innovative ways of extracting information from disparate, random sources

7 What Evidence? Evidence-Based Medicine Today –Randomized Control Trials (RCTs) Gold Standard Not relevant for many complex interventions –Systematic Literature Reviews White literature rules! Systematically throws out evidence based on quality threshold –Not available!

8 What Evidence? Grey Literature (not peer reviewed and published) –Local contextual information –New research –Often ‘reviewed’ by collegues and funding organisations –Language barrier

9 What Evidence?

10 The Challenge Encourage Evidence-based Policy Making –Use Strong evidence where available –Use Weak evidence where appropriate –Use Expert knowledge to bridge the gap Evidence informed and validated Model for understanding complex interactions –Model provides feedback into areas needing more research –‘Externalises’ community understanding

11 The Challenge Access –On a bookshelf in rural Ghana? Sensitive –May contain unpopular findings Quality –Not peer reviewed Organization –Not indexed

12 Requirements Domain driven evidence sharing –Finding relevant published papers –Freeing locally available information –Facilitating dynamic evidence evaluation through expert collaboration Bridge the network divide Machine linkable evidence for computer- based models Low Cost/Easy Maintenance

13 Requirements All evidence is represented by a citation –Papers, data, analyses, etc. Evidence-base is therefore shared –ontologies (OWL)? –Domain Knowledge-Base –Annotation Knowledge-Base (Annotea/COHSE?) –Citation Knowledge-Base Evidence can then be location agnostic –If I know it exists I can request it –Solves ownership problems

14 Requirements Browse & search documents using domain concepts Document Level Access Control Support for evidence desensitizing –Signoff workflows? Support for quality assessment –Quality checklist –Quality workflows

15 Sounds Like DSpace? Low Entry – Open Source Multiple asset format (docs, data, analyses) Manage ownership issues through citation interface, OpenURL support and metadata harvesting support Manage data input through submission workflows Document level access control

16 Typology Interface & Search (credits: M. Ferreira & A. Baptista – Univ. of Minho)

17 Multi-lingual

18 What’s Missing? Rich document modeling & linking –A Literature review needs to support reviewed abstracts & summary docs Rich Ontology support –Support knowledge discovery & sharing Distributed repository synchronisation –Working around bad network infrastructure –p2p Cleaner access control management

19 Thanks To MIT and HP for getting this community going To All those of you enhancing DSpace with new functionality and keeping the core product going. For Listening!