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p
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cr
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s
p
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ialties
.
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h
e
s
e
m
ee
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g
s
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k
n
o
wn
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tio
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p
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id
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a
ir
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(
R
C
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in
Fre
n
ch
[
1
]
,
p
lay
a
p
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tal
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le
in
d
ev
elo
p
in
g
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cip
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ee
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t
h
ey
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s
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clu
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m
p
lex
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f
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ata
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r
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ltip
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ef
f
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cies
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m
a
k
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itatio
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s
i
n
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n
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tem
s
.
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h
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allen
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es
ar
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ac
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ated
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h
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Evaluation Warning : The document was created with Spire.PDF for Python.
I
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&
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p
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n
g
I
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N:
2088
-
8
7
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To
w
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s
a
s
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n
d
a
r
d
iz
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en
terp
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is
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ch
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e:
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h
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n
cin
g
…
(
N
a
s
s
im
B
o
u
t
)
2225
to
MD
T
M
co
o
r
d
in
atio
n
an
d
d
ata
in
ter
o
p
er
ab
ilit
y
.
MD
T
M
s
ar
e
m
an
d
ated
b
y
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i
n
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an
y
co
u
n
tr
ies
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d
ar
e
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u
cial
in
d
ec
id
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g
tr
ea
tm
en
t
p
r
o
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ls
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ased
o
n
s
im
ilar
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s
es,
in
ter
n
atio
n
al
r
ep
o
s
ito
r
ies,
o
r
n
o
v
el
s
tu
d
ies
[
2
]
–
[
4
]
.
R
ec
en
t
s
tu
d
ies
h
av
e
h
ig
h
lig
h
t
ed
th
e
tr
an
s
f
o
r
m
ativ
e
im
p
ac
t
o
f
th
e
co
r
o
n
a
v
ir
u
s
d
is
ea
s
e
(
C
OVI
D
-
19)
p
an
d
em
ic
o
n
teleh
ea
lth
in
teg
r
atio
n
,
h
i
g
h
lig
h
tin
g
th
e
u
r
g
en
t
n
ee
d
f
o
r
im
p
r
o
v
ed
in
f
r
astru
ctu
r
e
a
n
d
r
eg
u
lato
r
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f
r
am
ewo
r
k
s
to
s
u
p
p
o
r
t
m
u
ltid
is
cip
lin
ar
y
ca
r
e
[
5
]
.
Ho
we
v
er
,
th
e
liter
atu
r
e
r
ev
ea
ls
p
er
s
is
ten
t
in
ef
f
icien
cies
in
MD
T
Ms
th
at
r
eq
u
ir
e
m
o
r
e
ad
v
an
ce
d
tech
n
o
lo
g
ical
s
o
lu
ti
o
n
s
,
p
ar
ticu
lar
ly
in
th
e
r
ea
lm
s
o
f
r
ea
l
-
tim
e
d
ata
in
teg
r
atio
n
a
n
d
d
ec
is
io
n
s
u
p
p
o
r
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s
y
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tem
s
.
R
ap
id
d
ep
lo
y
m
en
t
o
f
in
p
atien
t
telem
ed
icin
e
u
s
in
g
co
n
s
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er
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g
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ad
e
tech
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o
lo
g
y
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as
s
h
o
wn
ef
f
ec
t
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ess
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d
p
o
te
n
tial
p
er
m
a
n
en
ce
in
v
ar
io
u
s
h
ea
lth
ca
r
e
s
ettin
g
s
[
6
]
.
T
h
ese
f
in
d
in
g
s
ad
v
o
ca
te
f
o
r
en
h
an
ce
d
teleh
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lth
in
teg
r
atio
n
to
e
n
s
u
r
e
ef
f
icien
t a
n
d
ac
c
u
r
ate
p
ati
en
t c
ar
e
p
lan
n
in
g
.
Alth
o
u
g
h
g
lo
b
al
im
p
le
m
en
tat
io
n
s
o
f
telem
ed
icin
e,
s
u
ch
a
s
I
n
d
ia’
s
s
atellite
-
b
ased
a
p
p
r
o
ac
h
[
7
]
,
u
n
d
er
s
co
r
e
t
h
e
p
o
ten
tial
o
f
r
e
m
o
te
h
ea
lth
ca
r
e
d
eliv
e
r
y
,
th
e
i
n
teg
r
atio
n
o
f
in
ter
n
et
o
f
th
in
g
s
(
I
o
T
)
tech
n
o
lo
g
ies
f
u
r
th
er
e
n
h
an
ce
s
th
is
ca
p
ab
ilit
y
b
y
en
a
b
lin
g
r
ea
l
-
tim
e
d
ata
c
o
llectio
n
an
d
ad
v
an
ce
d
an
aly
ti
cs
[
8
]
,
h
ig
h
lig
h
tin
g
ad
v
an
ce
s
in
n
etwo
r
k
co
m
m
u
n
icatio
n
s
,
ar
tific
ial
in
tellig
en
ce
,
an
d
wea
r
ab
le
s
en
s
o
r
s
.
T
h
is
r
ev
iew
em
p
h
asizes
s
ig
n
if
ican
t
f
o
cu
s
o
n
I
o
T
-
b
ase
d
h
ea
lth
ca
r
e
ap
p
licatio
n
s
an
d
id
en
tifie
s
k
ey
o
p
p
o
r
tu
n
ities
f
o
r
f
u
tu
r
e
r
esear
ch
to
r
eso
lv
e
ex
is
tin
g
am
b
ig
u
ities
in
telem
ed
icin
e.
I
m
p
r
o
v
in
g
t
h
e
s
tr
u
ctu
r
e
an
d
tech
n
o
lo
g
y
b
eh
in
d
MD
T
Ms
is
cr
u
cial
f
o
r
en
h
a
n
cin
g
p
atien
t
o
u
tco
m
es
an
d
o
p
tim
izin
g
cl
in
ical
wo
r
k
f
lo
ws.
An
a
r
tific
ial
in
tellig
en
ce
(
AI
)
b
ased
en
ter
p
r
is
e
ar
ch
itectu
r
e
t
h
at
co
n
s
o
lid
ates
in
f
o
r
m
atio
n
a
n
d
f
ac
ilit
ates
b
etter
d
ec
is
io
n
-
m
ak
in
g
p
r
o
ce
s
s
es
i
s
ess
en
tial.
Oth
er
r
esear
ch
er
s
,
s
u
ch
as
T
u
m
m
er
s
et
a
l.
[
9
]
h
ig
h
lig
h
t
th
e
im
p
o
r
tan
ce
o
f
r
o
b
u
s
t
r
ef
er
en
ce
ar
ch
itectu
r
es
in
ad
d
r
ess
in
g
v
a
r
io
u
s
s
tak
eh
o
ld
er
co
n
ce
r
n
s
.
T
h
is
s
tu
d
y
aim
s
to
d
esig
n
an
en
ter
p
r
is
e
ar
ch
itectu
r
e
f
o
r
MD
T
Ms
i
n
o
n
co
lo
g
y
to
im
p
r
o
v
e
co
llab
o
r
atio
n
an
d
d
ec
is
io
n
-
m
ak
in
g
with
in
t
h
is
h
ea
lt
h
ca
r
e
c
o
n
tex
t.
T
h
e
m
eth
o
d
o
l
o
g
y
will
d
etail
th
e
r
esear
ch
ap
p
r
o
ac
h
,
in
clu
d
in
g
th
e
co
llectio
n
o
f
d
ata
f
r
o
m
th
e
ex
is
tin
g
liter
atu
r
e
,
th
e
an
aly
s
is
o
f
cu
r
r
e
n
t
MD
T
s
y
s
tem
s
,
an
d
th
e
d
esig
n
o
f
th
e
p
r
o
p
o
s
ed
AI
-
b
ased
en
t
er
p
r
is
e
ar
ch
itectu
r
e
f
r
am
ewo
r
k
.
T
o
ad
d
r
ess
th
ese
ch
allen
g
es,
th
is
s
tu
d
y
ad
v
a
n
ce
s
ex
is
tin
g
m
o
d
els
b
y
in
tr
o
d
u
ci
n
g
a
h
o
lis
tic
AI
-
b
ased
en
ter
p
r
is
e
ar
ch
itectu
r
e
t
h
at
n
o
t
o
n
ly
in
teg
r
ates
r
ea
l
-
tim
e
d
at
a
ac
ce
s
s
an
d
d
ec
is
io
n
s
u
p
p
o
r
t
b
u
t
also
ad
d
r
ess
es
in
ter
o
p
er
a
b
ilit
y
ch
allen
g
es,
cr
ea
tin
g
a
u
n
if
ied
f
r
am
ewo
r
k
f
o
r
MD
T
Ms,
th
is
ar
ch
itectu
r
e
aim
s
to
s
tr
ea
m
lin
e
th
e
co
llab
o
r
ativ
e
p
r
o
ce
s
s
an
d
im
p
r
o
v
e
p
atien
t
o
u
tco
m
es.
T
h
e
r
em
ain
d
er
o
f
th
is
p
ap
er
is
s
tr
u
ctu
r
ed
as
f
o
llo
ws:
T
h
is
I
n
tr
o
d
u
ctio
n
r
ev
iews
th
e
r
elev
an
t
liter
atu
r
e,
f
o
c
u
s
in
g
o
n
th
e
ch
allen
g
es
an
d
tech
n
o
l
o
g
ical
s
o
lu
tio
n
s
in
MD
T
Ms.
Sectio
n
2
o
u
tlin
es
th
e
r
esear
ch
m
eth
o
d
o
l
o
g
y
,
in
clu
d
in
g
d
ata
co
llectio
n
a
n
d
a
n
aly
s
is
tech
n
iq
u
es.
Sectio
n
3
p
r
esen
ts
th
e
p
r
o
p
o
s
e
d
AI
-
b
ased
en
te
r
p
r
is
e
ar
ch
itec
tu
r
e
an
d
d
is
cu
s
s
es its
p
o
ten
tial
im
p
ac
t o
n
MD
T
M
p
r
o
ce
s
s
es.
Fin
ally
,
s
ec
tio
n
4
co
n
clu
d
es
with
a
d
is
cu
s
s
io
n
o
f
th
e
s
tu
d
y
’
s
co
n
t
r
ib
u
tio
n
s
,
lim
itatio
n
s
,
an
d
s
u
g
g
esti
o
n
s
f
o
r
f
u
tu
r
e
r
esear
ch
.
A
r
ev
iew
o
f
th
e
liter
atu
r
e
r
e
v
ea
ls
th
at
MD
T
Ms
ar
e
p
iv
o
t
al
in
o
n
c
o
lo
g
y
,
f
ac
ilit
atin
g
c
o
llab
o
r
ativ
e
d
ec
is
io
n
-
m
ak
in
g
am
o
n
g
s
p
ec
i
alis
ts
.
Acc
o
r
d
in
g
to
[
1
0
]
,
MD
T
Ms
h
av
e
s
h
o
wn
s
ig
n
if
ica
n
t
p
o
s
itiv
e
im
p
ac
ts
,
with
4
0
%
o
f
p
ar
ticip
an
ts
c
o
n
f
ir
m
in
g
t
h
at
th
ese
m
ee
tin
g
s
f
ac
ilit
ate
o
p
tim
al
p
atien
t
ca
r
e
s
o
lu
tio
n
s
th
r
o
u
g
h
r
ig
o
r
o
u
s
d
eb
ate.
Ad
d
itio
n
ally
,
8
1
%
o
f
p
h
y
s
ician
s
in
tr
ain
in
g
r
ep
o
r
t
e
n
h
an
ce
d
d
ec
is
io
n
-
m
ak
in
g
ca
p
ab
ilit
ies
an
d
alig
n
m
en
t
with
ed
u
ca
tio
n
al
o
b
jectiv
es.
Ho
wev
er
,
th
e
s
tu
d
y
also
id
en
tifie
d
s
ig
n
if
i
ca
n
t
s
h
o
r
tco
m
in
g
s
,
in
clu
d
in
g
in
ad
e
q
u
ate
I
T
s
u
p
p
o
r
t,
wh
ich
af
f
ec
ts
2
6
%
o
f
p
a
r
ticip
an
ts
,
an
d
in
s
u
f
f
icien
t
r
e
al
-
tim
e
d
ata
e
n
tr
y
,
af
f
ec
tin
g
2
0
%.
T
h
ese
ch
allen
g
es
h
ig
h
lig
h
t
th
e
n
ee
d
f
o
r
im
p
r
o
v
e
d
tech
n
o
l
o
g
ical
in
f
r
astru
ctu
r
e
to
s
u
p
p
o
r
t
th
e
f
u
ll
p
o
ten
tial
o
f
MD
T
Ms
in
e
n
h
an
cin
g
p
atien
t
ca
r
e.
I
n
ad
e
q
u
ate
I
T
s
u
p
p
o
r
t
ca
n
lead
t
o
d
e
lay
s
in
in
f
o
r
m
atio
n
r
etr
iev
al
an
d
s
h
ar
in
g
d
u
r
in
g
MD
T
Ms,
p
o
ten
tially
co
m
p
r
o
m
is
in
g
th
e
tim
elin
ess
an
d
ac
cu
r
ac
y
o
f
tr
ea
tm
e
n
t
d
ec
is
io
n
s
.
Similar
ly
,
th
e
lack
o
f
r
ea
l
-
tim
e
d
ata
e
n
tr
y
ca
n
r
esu
lt
in
o
u
td
ated
i
n
f
o
r
m
atio
n
b
e
in
g
u
s
ed
in
cr
itical
d
is
cu
s
s
io
n
s
,
th
er
eb
y
in
c
r
ea
s
in
g
th
e
r
is
k
o
f
s
u
b
o
p
tim
al
p
a
tien
t
o
u
tco
m
es.
MD
T
Ms
in
f
l
u
en
ce
o
n
co
lo
g
y
b
y
p
r
o
v
id
i
n
g
m
u
ltip
le
th
er
a
p
eu
tic
o
p
tio
n
s
f
o
r
ca
n
ce
r
tr
ea
tm
e
n
t,
lev
er
ag
in
g
th
e
ex
p
er
tis
e
o
f
s
p
ec
ialis
ts
,
im
p
r
o
v
in
g
ca
r
e
q
u
ality
an
d
d
iag
n
o
s
tic
ac
cu
r
ac
y
,
a
n
d
en
a
b
lin
g
ea
r
lier
ca
s
e
d
is
cu
s
s
io
n
s
.
MD
T
Ms
en
co
m
p
ass
v
ar
io
u
s
p
r
o
f
ess
io
n
als,
in
clu
d
in
g
atten
d
i
n
g
p
h
y
s
ician
s
,
o
n
co
lo
g
is
ts
,
r
ad
io
lo
g
is
ts
,
an
d
r
ad
io
th
e
r
ap
is
ts
,
wh
o
d
elib
er
ate
o
n
p
atien
t
ca
s
es
u
s
in
g
th
e
MD
T
M
s
h
ee
t.
T
h
is
d
o
cu
m
en
t
in
teg
r
ates
p
atien
t
d
ata
f
r
o
m
th
e
elec
tr
o
n
ic
h
ea
lt
h
r
ec
o
r
d
(
E
HR
)
alo
n
g
with
p
er
s
o
n
al
n
o
tes
an
d
p
r
o
p
o
s
ed
tr
ea
tm
en
t
p
lan
s
[
3
]
,
[
1
1
]
.
Ho
we
v
er
,
E
HR
s
y
s
tem
s
o
f
ten
s
u
f
f
er
f
r
o
m
in
ter
o
p
er
a
b
ilit
y
is
s
u
es,
m
ak
in
g
it
ch
allen
g
in
g
to
in
te
g
r
ate
in
f
o
r
m
atio
n
f
r
o
m
d
if
f
er
en
t
s
p
ec
ialties
,
wh
ich
ca
n
h
in
d
er
co
llab
o
r
ativ
e
d
ec
is
io
n
-
m
ak
in
g
.
Acc
ess
ib
ilit
y
to
th
e
MD
T
M
s
h
ee
t
f
o
r
all
m
em
b
er
s
is
cr
u
cial,
wh
eth
er
m
ee
tin
g
s
ar
e
co
n
d
u
cted
in
-
p
er
s
o
n
o
r
v
ir
tu
ally
[
3
]
,
[
1
2
]
.
Vir
tu
al
MD
T
Ms
h
av
e
g
ain
e
d
im
p
o
r
tan
ce
d
u
e
to
tec
h
n
o
lo
g
ical
ad
v
an
ce
m
en
ts
an
d
th
e
C
OVI
D
-
1
9
p
an
d
em
ic
[
1
3
]
,
b
u
t
th
ese
p
latf
o
r
m
s
o
f
t
en
lack
r
o
b
u
s
t
d
ec
is
io
n
s
u
p
p
o
r
t
m
ec
h
an
is
m
s
,
lim
itin
g
th
eir
ef
f
ec
tiv
en
ess
in
co
m
p
lex
ca
s
e
d
is
cu
s
s
io
n
s
.
C
an
ce
r
ca
r
e
r
e
q
u
ir
es
co
llab
o
r
atio
n
ac
r
o
s
s
m
u
ltip
le
s
p
ec
ialti
es
d
u
e
to
its
co
m
p
lex
ity
.
Fo
r
ex
am
p
le,
b
r
ea
s
t
ca
n
ce
r
ca
s
es
ca
n
b
e
d
is
cu
s
s
ed
o
n
Mo
n
d
a
y
s
,
wh
ile
T
h
u
r
s
d
ay
s
co
u
ld
b
e
d
ed
icate
d
to
th
y
r
o
id
ca
n
ce
r
[
3
]
.
T
ab
le
1
ca
teg
o
r
izes th
e
ty
p
es
o
f
MD
T
M
m
ee
tin
g
s
,
ea
ch
tailo
r
ed
to
s
p
ec
if
ic
ca
n
ce
r
ty
p
es.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
0
8
8
-
8
7
0
8
I
n
t J E
lec
&
C
o
m
p
E
n
g
,
Vo
l.
15
,
No
.
2
,
Ap
r
il
20
25
:
2
2
2
4
-
2
2
3
6
2226
T
ab
le
1.
T
y
p
es
of
th
e
M
D
T
M
C
a
n
c
e
r
T
y
p
e
M
D
T
M
e
e
t
i
n
g
I
n
v
o
l
v
e
d
s
p
e
c
i
a
l
t
i
e
s
G
a
st
r
o
i
n
t
e
s
t
i
n
a
l
(
l
i
v
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Stan
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MD
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M
in
ter
o
p
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is
cr
u
cial.
Kr
au
s
s
et
a
l.
[
3
]
d
ev
elo
p
ed
a
n
au
to
m
ate
d
b
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s
in
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p
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m
ak
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g
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A
f
r
am
ewo
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k
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f
[
1
4
]
en
h
a
n
ce
s
th
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ef
f
icien
cy
o
f
MD
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M
b
y
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tr
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MD
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llo
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atio
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Fre
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ig
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lth
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r
ity
(
HAS)
an
d
th
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UK
n
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h
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lth
s
er
v
ice
(
NHS)
[
4
]
,
[
1
1
]
,
[
1
5
]
,
[
1
6
]
.
T
h
ese
g
u
id
elin
es
e
m
p
h
asize
s
tr
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ctu
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ed
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r
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E
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u
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p
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ac
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T
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s
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p
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clin
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wo
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tr
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p
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e
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ce
f
o
r
t
h
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to
o
ls
[
1
7
]
.
Ho
wev
er
,
th
e
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n
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r
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o
f
t
h
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ap
p
s
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to
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r
o
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wo
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k
f
lo
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em
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ch
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less
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s
.
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lo
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ch
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p
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to
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in
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o
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tr
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m
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tr
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t
q
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ality
.
T
h
e
in
teg
r
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n
o
f
ar
tific
ial
in
tellig
en
ce
(
AI
)
in
h
ea
lth
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r
e
en
ter
p
r
is
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ar
ch
itectu
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as
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p
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is
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in
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-
m
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in
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p
r
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c
ess
es.
L
y
s
ag
h
t
et
a
l.
[
1
8
]
d
is
cu
s
s
th
e
eth
ical
co
n
s
id
er
atio
n
s
an
d
b
e
n
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its
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f
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ass
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ak
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f
o
c
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s
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o
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im
p
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o
v
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m
en
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ef
f
icien
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h
ea
lth
ca
r
e
s
y
s
tem
s
.
Ho
wev
er
,
m
an
y
AI
-
d
r
iv
en
a
n
aly
tics
to
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ls
ar
e
im
p
lem
en
ted
in
is
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atio
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,
with
o
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t
f
u
ll
in
teg
r
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in
to
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b
r
o
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r
k
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lead
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to
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ted
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ak
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p
r
o
ce
s
s
es.
So
d
h
r
o
an
d
Z
ah
id
[
1
9
]
p
r
o
p
o
s
e
a
n
AI
-
e
n
a
b
led
f
r
a
m
ewo
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k
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tili
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f
o
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p
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to
m
an
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e
d
ata
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icien
tly
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d
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s
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r
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eliab
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p
atien
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m
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n
ito
r
in
g
,
y
et
th
e
ad
o
p
tio
n
o
f
s
u
c
h
tech
n
o
lo
g
ies
r
em
ain
s
lim
it
ed
d
u
e
to
p
r
ac
tical
im
p
lem
en
tatio
n
ch
allen
g
es.
Similar
ly
,
Kau
r
a
n
d
Ma
n
n
[
2
0
]
h
ig
h
lig
h
t
th
e
im
p
o
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ta
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ce
o
f
r
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tim
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ip
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aly
tics
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r
o
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g
h
a
n
AI
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ased
p
latf
o
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m
,
b
u
t
th
ese
to
o
ls
o
f
ten
lack
u
s
er
-
f
r
ien
d
ly
in
te
r
f
ac
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h
in
d
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in
g
th
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ad
o
p
tio
n
b
y
c
lin
ician
s
.
B
u
r
r
i
et
a
l.
[
2
1
]
ex
p
lo
r
e
s
u
s
tain
ab
le
AI
ar
ch
itectu
r
es
in
h
ea
lth
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f
o
cu
s
in
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t
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r
es
in
t
o
ex
is
tin
g
MD
T
Ms
is
n
o
t
y
et
f
u
lly
r
ea
lized
.
Fu
r
th
er
m
o
r
e,
Ma
s
u
d
a
et
a
l.
[
2
2
]
in
v
esti
g
at
e
th
e
ap
p
licatio
n
o
f
ad
ap
tiv
e
en
ter
p
r
is
e
ar
ch
itectu
r
e
in
d
ig
ital
h
ea
lth
ca
r
e,
p
ar
ticu
lar
ly
in
d
r
u
g
d
ev
el
o
p
m
en
t,
en
h
an
cin
g
p
r
o
ce
s
s
ef
f
icien
cy
an
d
k
n
o
wled
g
e
s
h
a
r
in
g
,
b
u
t
also
h
ig
h
lig
h
t th
e
s
ig
n
if
ican
t g
ap
s
th
at
n
ee
d
to
b
e
ad
d
r
ess
ed
.
I
n
Mo
r
o
cc
o
,
th
e
lack
o
f
a
leg
i
s
lativ
e
f
r
am
ewo
r
k
f
o
r
MD
T
M
s
f
o
r
ce
s
in
s
titu
tio
n
s
to
d
ev
elo
p
th
eir
o
wn
p
r
o
ce
d
u
r
es
[
2
3
]
.
Alig
n
in
g
th
es
e
p
r
o
ce
d
u
r
es
with
in
ter
n
atio
n
a
l
b
est
p
r
ac
tices
ca
n
im
p
r
o
v
e
th
er
ap
eu
tic
d
ec
is
io
n
m
ak
in
g
a
n
d
clin
ical
wo
r
k
f
lo
w
s
,
im
p
r
o
v
in
g
p
atien
t
o
u
tco
m
e
s
ac
r
o
s
s
o
n
co
lo
g
y
ce
n
ter
s
.
H
o
wev
er
,
th
e
a
b
s
en
ce
o
f
s
tan
d
ar
d
ize
d
p
r
o
to
co
ls
an
d
tech
n
o
lo
g
ical
in
f
r
astru
ctu
r
e
p
r
esen
ts
o
n
g
o
in
g
c
h
allen
g
es.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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2088
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r
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n
t
s
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l
t
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g
h
t
h
i
s
s
t
u
d
y
p
r
o
p
o
s
e
s
a
n
a
r
c
h
i
t
e
c
t
u
r
e
t
o
f
a
c
i
l
it
a
t
e
s
e
a
m
l
ess
d
a
t
a
e
x
c
h
a
n
g
e
a
n
d
u
n
i
f
o
r
m
d
e
c
i
s
i
o
n
-
m
a
k
i
n
g
p
r
o
c
e
s
s
e
s
b
et
w
e
e
n
m
u
l
ti
d
is
c
i
p
l
i
n
a
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y
t
e
a
m
s
,
i
t
i
s
i
m
p
o
r
t
a
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t
t
o
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m
p
h
a
s
iz
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t
h
at
t
h
i
s
w
o
r
k
is
p
r
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m
a
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il
y
t
h
e
o
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et
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.
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h
e
p
r
o
p
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d
a
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h
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ct
u
r
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s
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d
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v
en
a
n
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d
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s
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d
t
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e
n
e
r
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t
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a
t
m
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t
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c
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d
a
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s
b
y
a
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a
l
y
z
i
n
g
t
h
e
m
o
s
t
c
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r
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e
n
t
p
a
t
i
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n
t
d
a
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a
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n
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al
-
t
i
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e
.
T
h
is
s
y
s
t
e
m
e
n
s
u
r
e
s
th
a
t
M
D
T
M
at
t
e
n
d
e
es
a
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eq
u
i
p
p
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d
w
i
t
h
t
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e
m
o
s
t
ac
c
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a
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a
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d
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p
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to
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t
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m
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ed
d
e
c
i
s
i
o
n
s
a
b
o
u
t
p
a
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n
t
c
a
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e.
I
n
a
d
d
i
t
i
o
n
,
t
h
e
a
r
c
h
i
te
c
t
u
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i
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c
l
u
d
e
s
r
o
b
u
s
t
I
T
s
u
p
p
o
r
t
f
e
a
t
u
r
es
t
o
i
m
p
r
o
v
e
d
at
a
i
n
t
e
g
r
at
i
o
n
a
n
d
u
s
e
r
i
n
t
e
r
a
c
ti
o
n
,
a
d
d
r
e
s
s
i
n
g
k
e
y
li
m
i
t
at
i
o
n
s
i
n
c
u
r
r
e
n
t
M
D
T
M
p
r
a
c
t
i
c
es
.
H
o
w
e
v
e
r
,
t
h
e
p
r
a
c
ti
ca
l
e
f
f
e
c
t
i
v
e
n
es
s
o
f
t
h
es
e
i
m
p
r
o
v
e
m
e
n
t
s
w
il
l
r
e
q
u
i
r
e
e
m
p
i
r
i
ca
l
v
a
l
i
d
a
t
i
o
n
i
n
f
u
t
u
r
e
s
t
u
d
i
es
.
B
y
a
d
d
r
e
s
s
i
n
g
t
h
e
s
e
f
o
u
n
d
a
t
i
o
n
a
l
c
h
a
l
l
e
n
g
e
s
i
n
a
co
n
c
e
p
t
u
a
l
f
r
a
m
e
w
o
r
k
,
t
h
i
s
s
t
u
d
y
s
e
e
k
s
t
o
l
a
y
t
h
e
g
r
o
u
n
d
w
o
r
k
f
o
r
f
u
t
u
r
e
a
d
v
a
n
c
e
m
e
n
t
s
i
n
M
D
T
M
e
f
f
i
c
i
e
n
c
y
a
n
d
e
f
f
e
c
t
i
v
e
n
e
s
s
,
u
l
ti
m
a
t
el
y
a
i
m
i
n
g
t
o
e
n
h
a
n
c
e
c
l
i
n
i
c
al
d
e
c
is
i
o
n
-
m
a
k
i
n
g
a
n
d
im
p
r
o
v
e
p
a
t
i
e
n
t
o
u
t
c
o
m
e
s
ac
r
o
s
s
d
i
v
e
r
s
e
h
ea
l
t
h
c
a
r
e
s
et
t
i
n
g
s
.
2.
M
E
T
H
O
D
T
h
is
s
ec
tio
n
o
u
tlin
es
th
e
d
e
v
el
o
p
m
en
t o
f
an
AI
-
b
ased
e
n
ter
p
r
is
e
ar
ch
itectu
r
e
s
p
ec
if
ically
d
esig
n
ed
to
im
p
r
o
v
e
th
e
ef
f
icien
cy
a
n
d
e
f
f
ec
tiv
en
ess
o
f
MD
T
Ms
in
o
n
c
o
lo
g
y
.
T
h
e
s
tu
d
y
f
o
cu
s
es
o
n
ad
d
r
ess
in
g
ex
is
tin
g
ch
allen
g
es
in
MD
T
Ms
b
y
p
r
o
p
o
s
in
g
an
ar
ch
itectu
r
e
th
at
in
teg
r
ates
ad
v
an
ce
d
AI
tech
n
o
l
o
g
ies
to
s
tr
ea
m
lin
e
d
ec
is
io
n
-
m
ak
in
g
p
r
o
ce
s
s
es.
B
y
lev
er
ag
in
g
AI
-
d
r
iv
en
to
o
ls
,
th
e
p
r
o
p
o
s
ed
f
r
a
m
ewo
r
k
aim
s
to
p
r
o
v
id
e
p
h
y
s
ician
s
with
ev
i
d
en
ce
-
b
ased
r
ec
o
m
m
en
d
atio
n
s
th
at
ar
e
p
er
s
o
n
alize
d
t
o
ea
c
h
p
atien
t
c
ase,
en
s
u
r
in
g
m
o
r
e
ac
cu
r
ate
an
d
in
f
o
r
m
ed
tr
ea
tm
en
t
p
lan
s
.
T
h
is
in
teg
r
atio
n
s
ee
k
s
to
n
o
t
o
n
ly
o
p
tim
ize
clin
ical
wo
r
k
f
lo
ws
b
u
t
also
en
h
an
ce
th
e
o
v
er
all
q
u
ality
o
f
p
atien
t c
ar
e
in
o
n
co
l
o
g
y
s
ettin
g
s
.
2
.
1
.
Study
of
t
he
e
x
is
t
ing
s
i
t
u
a
t
i
o
n
Ou
r
s
tu
d
y
c
o
m
m
en
ce
d
with
an
in
-
d
e
p
th
an
al
y
s
is
o
f
th
e
e
x
is
tin
g
m
u
ltid
is
cip
lin
ar
y
tea
m
m
ee
tin
g
(
MD
T
M)
p
r
o
ce
d
u
r
es
at
th
e
r
eg
io
n
al
o
n
c
o
lo
g
y
ce
n
ter
(
R
OC
)
in
T
an
g
ier
an
d
th
e
T
a
n
g
ier
-
T
eto
u
an
-
A
l
Ho
ce
im
a
Un
iv
er
s
ity
Ho
s
p
ital
C
en
tr
e
(
UHC
T
T
A)
,
b
o
th
o
f
wh
ich
r
ely
o
n
th
e
E
NOVA
R
&
T
h
o
s
p
ital
in
f
o
r
m
atio
n
s
y
s
tem
.
T
h
is
an
aly
s
is
in
v
o
lv
e
d
co
n
d
u
ctin
g
f
ield
r
esear
c
h
th
at
in
clu
d
e
d
in
ter
v
iews
with
c
an
ce
r
s
p
ec
ialis
ts
to
g
ain
in
s
ig
h
ts
in
to
th
eir
e
x
p
er
i
en
ce
s
an
d
ch
allen
g
es
with
th
e
cu
r
r
en
t
s
y
s
tem
.
Ad
d
itio
n
ally
,
we
p
ar
ticip
ated
in
th
e
ac
ce
p
tan
ce
test
in
g
o
f
th
e
MD
T
M
m
o
d
u
le,
wh
ic
h
allo
w
ed
u
s
to
ev
alu
ate
its
f
u
n
ctio
n
ality
f
ir
s
th
an
d
.
T
h
is
co
m
p
r
eh
e
n
s
iv
e
ass
ess
m
en
t
r
ev
ea
led
s
ev
er
al
ar
ea
s
f
o
r
im
p
r
o
v
em
en
t,
p
a
r
ticu
lar
ly
in
d
ata
i
n
ter
o
p
er
ab
ilit
y
,
u
s
er
in
ter
ac
tio
n
,
an
d
s
y
s
tem
ad
ap
t
ab
ilit
y
,
h
ig
h
lig
h
tin
g
th
e
n
ee
d
f
o
r
a
m
o
r
e
a
d
v
an
ce
d
an
d
in
t
eg
r
ated
s
o
lu
tio
n
to
s
u
p
p
o
r
t d
ec
is
io
n
-
m
ak
in
g
p
r
o
c
ess
es.
T
h
e
cu
r
r
en
t
MD
T
M
p
r
o
ce
s
s
a
t
R
OC
T
an
g
ier
is
s
tr
u
ctu
r
ed
a
s
f
o
llo
ws:
T
h
e
atten
d
in
g
p
h
y
s
ician
f
ir
s
t
r
eg
is
ter
s
th
e
p
atien
t’
s
in
f
o
r
m
a
tio
n
o
n
an
MD
T
M
s
h
ee
t,
wh
ic
h
is
th
en
elec
tr
o
n
ically
tr
an
s
m
itted
f
o
r
d
is
cu
s
s
io
n
d
u
r
in
g
th
e
MD
T
M
s
ess
io
n
.
T
h
e
s
ess
io
n
in
v
o
lv
es
s
ev
er
al
cr
itical
s
tep
s
,
in
clu
d
in
g
r
e
v
iewin
g
n
ew
ca
s
es,
f
ilter
in
g
in
c
o
m
p
lete
o
n
es,
s
eq
u
en
tially
p
ass
in
g
MD
T
M
s
h
ee
ts
,
an
d
ass
ess
in
g
ea
ch
ca
s
e’
s
s
itu
atio
n
.
Ho
wev
er
,
f
u
n
ctio
n
al
d
is
cr
ep
a
n
cies
wer
e
id
en
tifie
d
,
s
u
ch
as
in
ad
eq
u
ate
d
ata
in
ter
o
p
er
a
b
ilit
y
,
lim
ited
f
ield
s
f
o
r
s
p
ec
ialis
t
n
o
tes,
an
d
i
n
s
u
f
f
icien
t
s
u
p
p
o
r
t
f
o
r
ex
te
r
n
al
MD
T
M
s
h
ee
ts
.
T
h
ese
s
h
o
r
tco
m
in
g
s
h
ig
h
lig
h
ted
th
e
n
ee
d
f
o
r
a
m
o
r
e
co
m
p
r
eh
e
n
s
iv
e
an
d
AI
-
in
teg
r
ated
s
o
lu
tio
n
to
s
tr
ea
m
lin
e
d
ec
is
io
n
m
ak
i
n
g
an
d
i
m
p
r
o
v
e
th
e
o
v
er
all
MD
T
M
p
r
o
ce
s
s
.
T
h
is
in
itial
an
aly
s
is
u
s
in
g
B
PMN
[
2
4
]
to
m
ap
o
u
t
th
e
e
x
is
tin
g
MD
T
M
wo
r
k
f
lo
ws,
h
ig
h
lig
h
tin
g
in
ef
f
icien
cies
an
d
g
ap
s
i
n
th
e
s
y
s
tem
'
s
d
esig
n
.
T
h
is
s
y
s
tem
atic
ap
p
r
o
ac
h
p
r
o
v
id
ed
a
c
lear
f
o
u
n
d
atio
n
f
o
r
co
n
ce
p
tu
alizin
g
a
n
ew
en
te
r
p
r
is
e
ar
ch
itectu
r
e
aim
ed
at
ad
d
r
ess
in
g
t
h
ese
lim
itatio
n
s
,
p
ar
ticu
lar
ly
b
y
in
teg
r
atin
g
AI
tech
n
o
lo
g
ies
to
im
p
r
o
v
e
d
ec
is
io
n
-
m
a
k
in
g
p
r
o
ce
s
s
es.
Dr
awin
g
f
r
o
m
p
r
ev
i
o
u
s
s
tu
d
ies,
in
s
ig
h
ts
in
to
th
e
tr
an
s
f
o
r
m
ativ
e
p
o
te
n
tial
o
f
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in
h
ea
lth
ca
r
e
b
ec
am
e
ev
id
en
t,
s
h
o
wca
s
in
g
th
e
ad
v
an
tag
es
o
f
in
co
r
p
o
r
atin
g
AI
i
n
to
MD
T
Ms.
T
h
e
wo
r
k
s
o
f
W
atso
n
f
o
r
o
n
c
o
lo
g
y
a
n
d
th
e
o
n
co
l
o
g
y
e
x
p
er
t
ad
v
is
o
r
[
2
5
]
–
[
2
7
]
f
u
r
th
er
v
alid
ated
th
ese
f
in
d
i
n
g
s
,
d
em
o
n
s
tr
atin
g
h
o
w
AI
-
d
r
i
v
en
s
y
s
tem
s
ca
n
en
h
an
ce
clin
ic
al
d
ec
is
io
n
-
m
ak
in
g
,
s
tr
ea
m
lin
e
wo
r
k
f
lo
ws,
an
d
p
r
o
v
id
e
ev
id
en
ce
-
b
ased
r
ec
o
m
m
e
n
d
atio
n
s
tailo
r
ed
to
p
atien
t
n
e
ed
s
.
T
h
ese
in
s
ig
h
ts
u
n
d
er
s
co
r
e
d
th
e
cr
itical
n
ee
d
f
o
r
a
m
o
d
er
n
ized
ar
c
h
itectu
r
e
th
at
lev
er
ag
es
AI
f
o
r
im
p
r
o
v
ed
ef
f
icien
c
y
an
d
o
u
tco
m
es in
m
u
ltid
is
cip
lin
ar
y
o
n
co
lo
g
y
ca
r
e.
2
.
2
.
Co
ncept
ua
liza
t
io
n
of
t
he
ent
er
pris
e
a
r
c
hi
t
e
c
t
u
re
To
f
o
r
m
u
late
our
v
is
io
n
f
o
r
an
in
ter
o
p
er
a
b
le
MD
T
M
m
o
d
u
le,
we
g
r
o
u
n
d
e
d
o
u
r
d
esig
n
in
th
e
p
r
in
cip
les
o
f
T
OGAF
en
ter
p
r
is
e
ar
ch
itec
tu
r
e
[
2
8
]
.
Usi
n
g
th
e
Ar
c
h
iMa
te
en
ter
p
r
is
e
ar
ch
itectu
r
e
m
o
d
e
llin
g
lan
g
u
ag
e
[
2
9
]
,
we
s
y
s
tem
atica
lly
ca
p
tu
r
ed
an
d
m
o
d
elled
th
e
a
r
ch
itectu
r
e,
en
s
u
r
in
g
alig
n
m
e
n
t
with
th
e
ar
ch
itectu
r
e
d
ev
elo
p
m
e
n
t
cy
cle.
T
h
is
ap
p
r
o
ac
h
in
teg
r
ates
k
ey
co
n
ce
p
ts
s
u
ch
as
m
o
tiv
atio
n
elem
en
ts
an
d
co
r
e
lay
er
s
to
en
co
m
p
ass
th
e
en
tire
ar
c
h
itectu
r
e
life
cy
cle
an
d
ac
h
iev
e
a
co
m
p
r
eh
en
s
iv
e
f
r
am
ewo
r
k
.
T
h
e
g
o
als
o
f
th
e
s
tak
eh
o
ld
er
s
ar
e
ad
d
r
ess
ed
u
s
in
g
m
o
tiv
atio
n
elem
en
ts
,
a
n
s
wer
in
g
th
e
“wh
at?”
Qu
esti
o
n
.
T
h
e
b
u
s
in
ess
,
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
0
8
8
-
8
7
0
8
I
n
t J E
lec
&
C
o
m
p
E
n
g
,
Vo
l.
15
,
No
.
2
,
Ap
r
il
20
25
:
2
2
2
4
-
2
2
3
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2228
ap
p
licatio
n
,
a
n
d
tech
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lo
g
y
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ay
er
s
r
ep
r
esen
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t
h
e
“h
o
w?”
q
u
esti
o
n
.
I
m
p
lem
en
tatio
n
a
n
d
m
ig
r
atio
n
elem
e
n
ts
ad
d
r
ess
ch
an
g
es a
n
d
im
p
ac
ts
,
an
s
wer
in
g
th
e
“wh
en
?”
an
d
“b
y
wh
at?”
Qu
esti
o
n
s
.
Fo
r
r
ef
er
en
ce
,
as
s
h
o
wn
in
Fig
u
r
e
1
is
a
v
is
u
al
o
v
er
v
iew
o
f
th
e
elem
en
ts
u
s
ed
in
th
is
s
tu
d
y
.
Fo
r
f
u
r
th
er
d
etails
o
n
Ar
ch
iMa
te
s
y
m
b
o
ls
an
d
th
eir
m
ea
n
in
g
s
,
th
e
o
f
f
icial
d
o
cu
m
e
n
tatio
n
an
d
s
o
u
r
ce
s
p
r
o
v
id
e
co
m
p
r
eh
e
n
s
iv
e
ex
p
la
n
atio
n
s
[
3
0
]
,
[
3
1
]
.
Fig
u
r
e
1.
Ar
ch
iMa
te
co
r
e
elem
en
ts
an
d
r
e
l
a
t
i
o
n
s
h
i
p
s
2
.
3
.
Co
mm
un
ica
t
io
n
m
et
ho
ds
a
nd
re
a
l
-
t
im
e
da
t
a
e
x
c
h
a
n
g
e
I
n
d
esig
n
in
g
th
e
ar
ch
itectu
r
e
,
p
ar
ticu
lar
atten
tio
n
was
p
ai
d
to
th
e
co
m
m
u
n
icatio
n
m
et
h
o
d
s
u
s
ed
b
etwe
en
th
e
s
y
s
tem
s
in
v
o
lv
ed
in
MD
T
M.
T
h
e
ar
c
h
itectu
r
e
s
u
p
p
o
r
ts
r
ea
l
-
tim
e
d
ata
ex
ch
an
g
e
t
h
r
o
u
g
h
R
E
STf
u
l
API
s
,
wh
ich
f
ac
ilit
ate
co
m
m
u
n
icatio
n
b
etwe
en
t
h
e
elec
tr
o
n
ic
h
ea
lth
r
ec
o
r
d
(
E
H
R
)
s
y
s
tem
s
an
d
th
e
AI
d
ec
is
io
n
s
u
p
p
o
r
t
m
o
d
u
le.
T
h
e
R
E
STf
u
l
API
s
wer
e
ch
o
s
en
f
o
r
t
h
eir
s
ca
lab
ilit
y
,
s
tatele
s
s
n
atu
r
e,
a
n
d
ab
ilit
y
to
s
u
p
p
o
r
t
a
wid
e
r
an
g
e
o
f
d
ata
f
o
r
m
ats
(
e.
g
.
,
J
SON,
XM
L
)
,
m
ak
in
g
th
e
m
s
u
itab
le
f
o
r
in
teg
r
atin
g
v
ar
io
u
s
h
ea
lth
-
ca
r
e
ap
p
licatio
n
s
.
R
ea
l
-
tim
e
d
ata
ex
ch
an
g
e
is
c
r
u
cial
to
en
s
u
r
e
th
at
all
MD
T
M
p
ar
ticip
an
ts
h
av
e
ac
ce
s
s
to
th
e
m
o
s
t
cu
r
r
en
t
p
atien
t
d
ata.
T
o
ac
h
i
ev
e
th
is
,
th
e
a
r
ch
itectu
r
e
in
c
o
r
p
o
r
ates
W
eb
So
ck
et
tech
n
o
l
o
g
y
,
wh
ich
e
n
ab
les
co
n
tin
u
o
u
s
two
-
way
co
m
m
u
n
i
ca
tio
n
b
etwe
en
clien
t
a
p
p
licatio
n
s
(
s
u
ch
as
th
o
s
e
u
s
ed
b
y
atten
d
in
g
p
h
y
s
ician
s
)
an
d
th
e
s
er
v
er
h
o
s
tin
g
th
e
AI
d
ec
is
io
n
s
u
p
p
o
r
t
s
y
s
tem
.
T
h
is
s
etu
p
allo
ws
in
s
tan
tan
eo
u
s
u
p
d
ates
to
p
atien
t
r
ec
o
r
d
s
,
en
s
u
r
in
g
th
at
an
y
n
e
w
in
f
o
r
m
atio
n
e
n
ter
ed
b
y
a
team
m
em
b
er
is
im
m
ed
iately
av
ailab
le
to
all
o
th
er
s
.
Data
in
ter
o
p
e
r
ab
ilit
y
is
f
u
r
th
er
en
h
an
ce
d
b
y
im
p
lem
en
tin
g
th
e
f
ast
h
ea
lth
ca
r
e
i
n
ter
o
p
er
ab
ilit
y
r
eso
u
r
ce
s
(
FHI
R
)
s
tan
d
ar
d
,
wh
ich
p
r
o
v
id
es
a
co
n
s
is
ten
t
f
r
am
ewo
r
k
f
o
r
d
ata
e
x
ch
an
g
e
b
etwe
en
d
if
f
er
en
t
h
ea
lth
ca
r
e
s
y
s
tem
s
.
T
h
e
m
o
d
u
lar
co
m
p
o
n
en
ts
o
f
FHI
R
allo
w
th
e
ar
ch
itectu
r
e
to
ad
ap
t
to
v
ar
io
u
s
E
H
R
s
y
s
tem
s
,
en
s
u
r
in
g
s
ea
m
less
in
teg
r
atio
n
b
etwe
en
d
if
f
er
en
t
h
o
s
p
ital settin
g
s
.
2
.
4
.
AI
mo
dels
in decisi
o
n
s
up
po
rt
s
y
s
t
em
s
T
h
e
AI
co
m
p
o
n
en
t
o
f
th
e
ar
ch
itectu
r
e
is
d
esig
n
ed
to
s
u
p
p
o
r
t
d
ec
is
io
n
-
m
ak
in
g
p
r
o
ce
s
s
es
b
y
an
aly
zin
g
p
atien
t
d
ata
an
d
p
r
o
v
id
in
g
tr
ea
tm
e
n
t
r
ec
o
m
m
en
d
atio
n
s
.
T
h
e
AI
m
o
d
els
u
tili
ze
d
in
t
h
is
s
y
s
tem
in
clu
d
e
s
u
p
e
r
v
is
ed
lear
n
i
n
g
al
g
o
r
ith
m
s
tr
ain
e
d
o
n
lar
g
e
d
ata
s
ets
o
f
h
is
to
r
ical
p
atien
t
o
u
tco
m
es.
Sp
ec
if
ically
,
th
e
ar
ch
itectu
r
e
em
p
lo
y
s
g
r
a
d
ien
t
b
o
o
s
tin
g
alg
o
r
ith
m
s
(
s
u
ch
as
XGBo
o
s
t)
f
o
r
p
r
e
d
ictiv
e
an
al
y
tics
,
wh
ich
h
av
e
b
ee
n
s
h
o
wn
to
p
er
f
o
r
m
well
in
m
ed
ical
d
ec
is
io
n
s
u
p
p
o
r
t
s
ce
n
ar
io
s
d
u
e
to
th
eir
ab
il
ity
to
h
an
d
le
lar
g
e,
co
m
p
lex
d
atasets
with
m
u
ltip
le
f
ea
tu
r
es.
I
n
ad
d
itio
n
to
p
r
e
d
ictiv
e
m
o
d
els,
th
e
ar
ch
itectu
r
e
in
teg
r
a
tes
n
atu
r
al
lan
g
u
ag
e
p
r
o
ce
s
s
in
g
(
NL
P)
tech
n
iq
u
es
to
an
aly
ze
u
n
s
tr
u
ct
u
r
ed
d
ata,
s
u
ch
as
p
h
y
s
ician
n
o
tes
an
d
r
esear
ch
ar
ticles.
T
h
is
ca
p
ab
ilit
y
allo
ws
th
e
AI
s
y
s
tem
to
p
r
o
v
id
e
r
ec
o
m
m
en
d
atio
n
s
th
at
c
o
n
s
id
er
b
o
th
s
tr
u
ctu
r
ed
E
HR
d
ata
an
d
th
e
latest
m
e
d
ical
liter
atu
r
e,
en
s
u
r
in
g
th
at
tr
ea
tm
en
t su
g
g
esti
o
n
s
ar
e
b
o
th
ev
i
d
e
n
ce
-
b
ased
an
d
co
n
tex
tu
ally
r
el
ev
an
t.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J E
lec
&
C
o
m
p
E
n
g
I
SS
N:
2088
-
8
7
0
8
To
w
a
r
d
s
a
s
ta
n
d
a
r
d
iz
ed
en
terp
r
is
e
a
r
ch
itectu
r
e:
en
h
a
n
cin
g
…
(
N
a
s
s
im
B
o
u
t
)
2229
T
h
e
AI
d
ec
is
io
n
s
u
p
p
o
r
t
s
y
s
tem
is
d
esig
n
ed
to
b
e
tr
an
s
p
ar
en
t
an
d
in
ter
p
r
etab
le,
p
r
o
v
i
d
in
g
ex
p
lan
atio
n
s
f
o
r
its
r
ec
o
m
m
e
n
d
atio
n
s
to
en
s
u
r
e
th
at
p
h
y
s
ician
s
ca
n
tr
u
s
t
an
d
u
n
d
e
r
s
tan
d
th
e
b
asis
f
o
r
th
e
s
u
g
g
ested
tr
ea
tm
en
ts
.
T
ec
h
n
iq
u
es
s
u
ch
as
Sh
ap
ley
a
d
d
itiv
e
ex
p
lan
atio
n
s
(
SHAP
)
ar
e
u
s
ed
to
p
r
o
v
id
e
th
ese
in
ter
p
r
etab
ilit
y
f
ea
tu
r
es,
wh
ic
h
ar
e
cr
u
cial
in
clin
ical
s
ettin
g
s
wh
er
e
tr
u
s
t in
AI
s
y
s
tem
s
is
ess
en
tial.
2
.
5
.
I
m
ple
m
ent
a
t
io
n
a
nd
t
e
s
t
i
n
g
Alth
o
u
g
h
th
e
a
r
ch
itectu
r
e
p
r
o
v
id
es
a
g
lo
b
al
p
e
r
s
p
ec
tiv
e
o
n
AI
in
teg
r
atio
n
in
to
M
DT
Ms,
th
e
im
p
lem
en
tatio
n
s
tr
ateg
y
em
p
h
asizes
m
o
d
u
lar
ity
an
d
ad
a
p
t
ab
ilit
y
,
allo
win
g
f
o
r
in
c
r
em
e
n
tal
ad
o
p
tio
n
o
f
th
e
s
y
s
tem
ac
r
o
s
s
d
if
f
er
en
t
h
ea
lth
ca
r
e
f
ac
ilit
ies.
A
p
ilo
t
im
p
lem
en
tatio
n
at
th
e
R
OC
T
an
g
ier
is
p
lan
n
ed
as
p
ar
t
o
f
a
s
u
b
s
eq
u
en
t
p
h
ase
o
f
th
e
p
r
o
ject,
wh
ich
will
in
v
o
lv
e
f
u
r
th
er
s
tep
s
s
u
ch
as
UM
L
m
o
d
elin
g
,
d
ata
s
ch
em
a
d
ev
elo
p
m
e
n
t,
an
d
th
e
co
d
i
n
g
p
r
o
ce
s
s
,
all
co
n
d
u
cted
u
n
d
er
th
e
SC
R
UM
m
eth
o
d
o
lo
g
y
.
T
h
is
p
h
ase
will
in
teg
r
ate
a
g
en
er
ativ
e
p
r
e
-
tr
ai
n
ed
tr
an
s
f
o
r
m
er
(
GPT)
m
o
d
e
l
[
3
2
]
as
th
e
co
r
e
AI
co
m
p
o
n
en
t,
wh
ich
will
b
e
in
co
r
p
o
r
ated
in
to
th
e
ex
is
tin
g
E
NOVA
R
&
T
s
y
s
tem
.
I
n
itial
t
esti
n
g
,
as
p
ar
t
o
f
th
is
f
u
tu
r
e
wo
r
k
,
will
co
m
p
ar
e
GPT
-
g
en
er
ated
r
ec
o
m
m
en
d
at
io
n
s
with
th
o
s
e
m
ad
e
b
y
th
e
m
u
ltid
is
cip
lin
ar
y
team
t
o
ass
ess
b
o
th
th
e
co
n
co
r
d
an
ce
an
d
ef
f
ec
tiv
en
ess
o
f
th
e
AI
s
y
s
tem
.
Giv
en
th
e
ad
ap
tab
le
n
atu
r
e
o
f
th
e
ar
ch
itectu
r
e,
th
e
s
y
s
tem
is
d
esig
n
ed
to
b
e
s
ca
lab
le
ac
r
o
s
s
v
ar
io
u
s
o
n
co
lo
g
y
ce
n
ter
s
,
en
s
u
r
in
g
th
at
it
ca
n
m
ee
t
th
e
d
iv
er
s
e
n
ee
d
s
o
f
d
if
f
er
en
t
h
ea
lth
ca
r
e
en
v
i
r
o
n
m
en
ts
.
Alth
o
u
g
h
th
is
s
tu
d
y
f
o
cu
s
s
es
o
n
th
e
cr
e
atio
n
o
f
an
ar
ch
itectu
r
e
b
ased
o
n
th
eo
r
etica
l
asp
ec
ts
,
th
e
f
u
tu
r
e
im
p
lem
en
tatio
n
o
f
th
e
GPT
m
o
d
el
with
in
th
is
ar
ch
itectu
r
e
is
ex
p
ec
ted
to
s
ig
n
if
ican
tly
en
h
an
ce
d
ec
is
io
n
-
m
ak
in
g
p
r
o
ce
s
s
es a
n
d
p
r
o
v
id
e
a
r
o
b
u
s
t
f
r
am
ewo
r
k
f
o
r
ad
v
an
ce
m
en
ts
in
d
ig
ital
h
e
alth
ca
r
e.
I
n
co
n
cl
u
s
io
n
,
th
e
in
teg
r
atio
n
o
f
AI
i
n
to
th
e
en
ter
p
r
is
e
ar
ch
itectu
r
e
o
f
MD
T
Ms
r
ep
r
esen
ts
a
s
ig
n
if
ic
an
t
ad
v
an
ce
m
e
n
t
in
th
e
m
an
a
g
em
en
t
o
f
o
n
co
lo
g
y
ca
s
es.
B
y
lev
er
ag
in
g
AI
tech
n
o
lo
g
ies,
s
u
ch
as
th
o
s
e
u
s
ed
in
W
atso
n
f
o
r
o
n
co
lo
g
y
a
n
d
th
e
o
n
co
lo
g
y
ex
p
e
r
t
ad
v
is
o
r
,
an
d
f
o
cu
s
in
g
o
n
r
ea
l
-
tim
e
d
ata
ex
ch
an
g
e
an
d
co
m
m
u
n
icatio
n
m
eth
o
d
s
,
o
u
r
p
r
o
p
o
s
ed
ar
ch
itectu
r
e
o
f
f
er
s
a
co
m
p
r
e
h
en
s
iv
e,
ad
ap
tab
le
s
o
lu
tio
n
th
at
en
h
an
ce
s
d
ec
is
io
n
-
m
ak
in
g
p
r
o
ce
s
s
es
an
d
im
p
r
o
v
es
p
atien
t
o
u
tco
m
es.
As
th
e
ar
ch
itectu
r
e
was
co
n
c
ep
tu
alize
d
b
ased
o
n
th
e
id
en
t
if
ied
g
ap
s
in
e
x
is
tin
g
s
y
s
tem
s
an
d
th
e
th
eo
r
etica
l
f
r
am
ewo
r
k
s
d
is
cu
s
s
ed
,
th
e
f
o
llo
win
g
R
esu
lts
an
d
Dis
cu
s
s
io
n
s
ec
tio
n
will
ex
p
lo
r
e
th
e
p
o
te
n
tial
im
p
ac
t
o
f
th
is
ar
ch
itectu
r
e
o
n
d
ec
is
io
n
-
m
ak
in
g
p
r
o
ce
s
s
es
w
ith
in
MD
T
Ms.
I
t
will
o
u
tlin
e
h
o
w
th
e
p
r
o
p
o
s
ed
s
y
s
tem
ad
d
r
ess
es
cu
r
r
en
t
lim
i
tatio
n
s
an
d
p
r
o
v
id
e
a
r
o
a
d
m
a
p
f
o
r
f
u
tu
r
e
r
esear
ch
o
p
p
o
r
tu
n
ities
.
T
h
is
in
clu
d
es
th
e
p
o
ten
tial
f
o
r
test
in
g
an
d
v
alid
atio
n
b
y
o
th
er
r
esear
c
h
er
s
o
r
p
r
ac
titi
o
n
er
s
,
o
f
f
e
r
in
g
an
o
p
p
o
r
t
u
n
ity
to
ev
alu
ate
th
e
s
y
s
tem
’
s
p
er
f
o
r
m
an
ce
,
s
ca
lab
ilit
y
,
an
d
a
d
ap
tab
i
lity
ac
r
o
s
s
d
if
f
er
en
t
h
ea
lth
ca
r
e
s
ettin
g
s
.
3.
R
E
S
UL
T
S
A
ND
D
I
S
CU
SS
I
O
N
I
n
th
is
s
ec
tio
n
,
we
p
r
esen
t
th
e
co
r
e
f
in
d
in
g
s
o
f
o
u
r
r
esear
ch
,
d
etailin
g
th
e
co
n
ce
p
tu
al
f
o
u
n
d
atio
n
s
o
f
th
e
p
r
o
p
o
s
ed
ar
c
h
itectu
r
e
an
d
th
e
an
ticip
ated
b
en
ef
its
o
f
AI
in
teg
r
atio
n
in
MD
T
Ms.
T
h
e
ar
ch
itectu
r
e
is
d
esig
n
ed
to
e
n
h
an
ce
g
en
e
r
icity
an
d
i
n
ter
o
p
e
r
ab
ilit
y
b
y
o
r
g
an
izin
g
th
e
s
y
s
tem
as
a
co
l
lectio
n
o
f
lo
o
s
ely
co
u
p
led
s
er
v
ices
(
m
ic
r
o
s
er
v
i
ce
s
)
.
Un
d
er
s
tan
d
i
n
g
th
e
Ar
ch
iMa
te
n
o
tatio
n
is
cr
u
cial
f
o
r
m
a
n
ag
in
g
th
e
co
m
p
lex
ity
o
f
th
e
p
r
o
p
o
s
ed
en
ter
p
r
is
e
ar
ch
itectu
r
e;
h
e
n
ce
,
an
o
v
er
v
iew
o
f
th
e
Ar
c
h
iMa
te
co
r
e
lay
er
s
’
elem
en
ts
an
d
th
eir
r
elatio
n
s
h
ip
s
is
d
escr
ib
ed
in
[
3
1
]
.
Alth
o
u
g
h
o
u
r
f
in
d
in
g
s
d
o
n
o
t in
clu
d
e
em
p
ir
ical
m
ea
s
u
r
e
m
en
t
s
,
th
e
ex
p
lo
r
ato
r
y
n
atu
r
e
o
f
th
i
s
s
tu
d
y
is
in
ten
d
ed
to
lay
th
e
f
o
u
n
d
ati
o
n
f
o
r
f
u
tu
r
e
r
esear
ch
.
T
h
e
p
r
o
p
o
s
ed
ar
c
h
itectu
r
e
s
er
v
e
s
as
a
co
n
ce
p
tu
al
f
r
am
ewo
r
k
f
o
r
in
teg
r
atin
g
AI
in
to
MD
T
Ms,
o
f
f
er
i
n
g
a
n
ew
av
en
u
e
f
o
r
im
p
r
o
v
in
g
d
ec
is
io
n
-
m
ak
in
g
p
r
o
ce
s
s
es
in
o
n
co
lo
g
y
.
B
y
f
o
cu
s
in
g
o
n
th
e
d
esig
n
an
d
s
tr
ateg
ic
elem
en
ts
,
th
is
s
tu
d
y
em
p
h
asizes
th
e
im
p
o
r
tan
ce
o
f
f
u
r
th
er
em
p
ir
ical
v
alid
atio
n
t
o
ass
ess
th
e
ef
f
ec
tiv
en
ess
an
d
s
ca
lab
ilit
y
o
f
t
h
e
ar
c
h
itectu
r
e
in
r
ea
l
-
w
o
r
ld
s
ettin
g
s
.
Desp
ite
th
e
r
o
b
u
s
tn
ess
o
f
E
NOVA
R
&
T
’
s
ex
is
tin
g
ar
ch
itectu
r
es,
th
ey
f
all
s
h
o
r
t
in
ad
d
r
ess
in
g
th
e
s
p
ec
if
ic
n
ee
d
s
o
f
an
AI
s
er
v
ice
s
y
s
tem
tailo
r
ed
f
o
r
th
e
o
n
c
o
lo
g
y
s
er
v
ice.
T
h
e
lim
i
tatio
n
s
id
en
tifie
d
,
p
ar
ticu
lar
ly
th
e
lack
o
f
d
e
d
ica
ted
AI
co
m
p
o
n
e
n
ts
an
d
th
e
co
m
p
lex
ity
o
f
th
e
o
n
co
l
o
g
ical
c
o
n
tex
t,
n
ec
ess
itated
th
e
d
ev
elo
p
m
en
t
o
f
a
n
ew
MD
T
M
m
o
d
el.
T
h
e
m
o
d
el
in
Fig
u
r
e
2
,
is
ex
p
licitly
d
esig
n
ed
to
s
u
p
p
o
r
t
th
e
MD
T
M
co
m
m
ittee’
s
task
s
b
y
in
teg
r
atin
g
AI
f
u
n
ctio
n
alit
ies
th
at
o
p
er
ate
in
d
e
p
en
d
e
n
t
ly
o
f
th
e
ex
is
tin
g
E
NOVA
R
&
T
in
f
o
r
m
atio
n
s
y
s
tem
s
.
3
.
1
.
I
m
ple
m
ent
a
t
io
n
a
nd
m
i
g
ra
t
io
n
v
i
e
w
p
o
i
n
t
T
h
e
im
p
lem
e
n
tatio
n
an
d
m
i
g
r
atio
n
v
iewp
o
in
t,
as
d
e
p
ict
ed
in
Fig
u
r
e
3
,
p
r
o
v
id
es
a
s
tr
u
ctu
r
ed
f
r
am
ewo
r
k
f
o
r
i
d
en
tify
in
g
an
d
im
p
lem
en
tin
g
en
h
a
n
ce
m
en
t
s
to
o
u
r
en
ter
p
r
is
e
ar
ch
itectu
r
e.
T
h
is
v
iewp
o
in
t
is
g
r
o
u
n
d
ed
in
th
e
c
o
n
ce
p
t
u
al
u
n
d
er
p
in
n
in
g
s
o
f
th
e
m
o
d
el
elem
en
ts
an
d
th
eir
in
ter
r
elatio
n
s
,
as
o
u
tlin
ed
in
[
3
1
]
,
an
d
p
lay
s
an
in
s
tr
u
m
en
tal
r
o
l
e
in
alig
n
in
g
p
r
o
g
r
am
s
an
d
p
r
o
jects
with
th
e
ar
ch
itectu
r
al
co
m
p
o
n
en
ts
th
ey
ar
e
d
esig
n
ed
to
tr
a
n
s
f
o
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ea
ch
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s
s
ea
m
less
l
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th
e
o
p
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als
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f
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Ms,
f
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atic
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an
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f
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m
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e
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r
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tate
to
an
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ce
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en
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led
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y
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th
at
is
b
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eq
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ip
p
ed
to
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ee
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th
e
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y
n
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m
ic
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ee
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r
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t
h
ig
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ey
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tep
s
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th
e
t
r
an
s
f
o
r
m
atio
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p
r
o
ce
s
s
,
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u
ch
as
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ap
tin
g
wo
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k
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lo
w
s
,
en
h
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cin
g
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ter
o
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r
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d
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co
r
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atin
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s
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h
a
n
is
m
s
to
im
p
r
o
v
e
ca
r
e
d
eliv
er
y
.
T
h
is
s
tr
u
ctu
r
ed
ap
p
r
o
ac
h
n
o
t
o
n
ly
p
r
o
m
o
tes
co
n
s
is
ten
cy
ac
r
o
s
s
d
if
f
er
en
t
i
m
p
lem
en
tatio
n
s
tag
es
b
u
t
also
en
s
u
r
es
th
at
th
e
a
r
ch
itectu
r
e
r
em
ain
s
ad
ap
tab
le
to
ev
o
lv
in
g
h
ea
lth
c
ar
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r
eq
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i
r
em
en
ts
,
p
av
in
g
th
e
way
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o
r
m
o
r
e
ef
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d
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atien
t
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ce
n
t
r
ic
m
u
ltid
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cip
lin
ar
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team
m
ee
tin
g
s
.
Fig
u
r
e
2.
C
u
r
r
en
t
s
tu
d
y
’
s
MD
T
m
ee
tin
g
s
r
e
p
r
esen
tatio
n
u
s
in
g
A
r
c
h
i
M
a
t
e
3
.
2
.
M
o
t
iv
a
t
io
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a
nd
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s
ines
s
l
a
y
e
r
I
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o
u
r
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r
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p
o
s
ed
m
o
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el
in
Fi
g
u
r
e
4,
th
e
ar
ch
itectu
r
al
f
r
a
m
ewo
r
k
is
s
tr
u
ctu
r
ed
t
o
alig
n
with
th
e
s
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ateg
ic
o
b
jectiv
es
o
f
th
e
s
t
ak
eh
o
ld
er
s
,
p
r
im
ar
ily
th
e
M
DT
M
co
m
m
ittee.
T
h
e
c
o
r
e
o
f
th
is
f
r
am
ewo
r
k
in
clu
d
es
m
o
tiv
atio
n
elem
e
n
ts
t
h
at
en
ca
p
s
u
late
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e
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r
im
ar
y
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o
n
ce
r
n
s
o
f
th
e
MD
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M
c
o
m
m
itt
ee
,
s
u
p
p
o
r
ted
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et
o
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p
r
er
e
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u
is
ites
f
u
lf
illed
b
y
d
esig
n
ated
b
u
s
in
ess
s
er
v
ices.
T
h
e
b
u
s
in
ess
lay
er
of
th
e
a
r
ch
i
tectu
r
e
in
clu
d
es
s
ev
er
al
k
ey
c
o
m
p
o
n
e
n
t
s
:
a.
B
u
s
in
ess
ac
to
r
s
:
m
em
b
er
s
o
f
th
e
MD
T
M
co
m
m
ittee
a
n
d
a
d
ata
s
cien
tis
t
,
wh
o
c
o
llectiv
ely
d
r
iv
e
th
e
d
ec
is
io
n
-
m
ak
in
g
p
r
o
ce
s
s
es.
b.
R
o
les
an
d
s
er
v
ices:
ea
c
h
ac
to
r
is
ass
o
ciate
d
with
s
p
ec
if
ic
r
o
les
s
u
p
p
o
r
ted
b
y
b
u
s
in
ess
s
er
v
ices.
A
cr
itical
s
er
v
ice,
f
o
r
e
x
am
p
le,
is
th
e
r
e
v
is
io
n
o
f
th
e
E
HR
s
u
m
m
ar
y
.
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c.
B
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ess
p
r
o
ce
s
s
es:
th
ese
ar
e
th
e
o
p
er
atio
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al
ac
tiv
ities
th
at
r
ea
lize
th
e
b
u
s
in
ess
s
er
v
ices,
o
r
g
an
ized
in
t
o
a
wo
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k
f
lo
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tiv
ated
b
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t
h
e
M
DT
M’
s
in
itiatio
n
.
At
th
e
f
o
u
n
d
atio
n
o
f
th
e
b
u
s
in
ess
lay
er
ar
e
b
u
s
in
ess
p
r
o
c
ess
es,
m
an
ag
ed
b
y
th
e
a
p
p
lic
atio
n
lay
er
,
wh
ich
en
s
u
r
es th
at
all
n
ec
ess
ar
y
d
ata
ar
e
ac
cu
r
ately
p
r
o
ce
s
s
ed
an
d
av
ailab
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d
u
r
in
g
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m
ee
tin
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.
Fig
u
r
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3
.
C
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r
r
e
n
t
s
tu
d
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s
im
p
lem
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tatio
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an
d
m
ig
r
atio
n
ar
ch
itectu
r
e
Fig
u
r
e
4
.
Mo
tiv
ati
o
n
an
d
b
u
s
in
ess
r
ep
r
esen
tatio
n
3
.
3
.
B
us
ines
s
a
nd
a
pp
lica
t
io
n
l
a
y
e
r
s
T
h
e
ap
p
licatio
n
ar
ch
itectu
r
e
d
elin
ea
tes
th
e
s
tr
u
ctu
r
e
,
b
eh
av
io
r
,
an
d
i
n
ter
ac
tio
n
s
o
f
in
teg
r
ated
ap
p
licatio
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s
.
I
n
o
u
r
r
ef
in
ed
ar
ch
itectu
r
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r
o
p
o
s
itio
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wn
in
Fig
u
r
e
5
,
two
ad
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i
tio
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ap
p
licatio
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s
(
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ec
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p
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o
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t
m
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ag
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ated
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g
E
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&
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’
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E
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San
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ap
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Mic
r
o
s
o
f
t
T
ea
m
s
.
T
h
ese
ap
p
licatio
n
s
ar
e
cr
u
cial
f
o
r
ess
en
tial
s
er
v
ices
lik
e
m
ee
tin
g
m
an
a
g
em
en
t
an
d
d
ec
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s
io
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au
g
m
en
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n
,
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ir
ec
tly
s
u
p
p
o
r
tin
g
u
n
d
er
ly
in
g
b
u
s
in
ess
p
r
o
ce
s
s
es.
a.
Dec
is
io
n
s
u
p
p
o
r
t
ap
p
licatio
n
:
en
h
a
n
ce
s
d
ec
is
io
n
-
m
ak
in
g
ca
p
ab
ilit
ies
b
y
p
r
o
v
id
in
g
co
m
p
r
eh
en
s
iv
e,
d
ata
-
d
r
iv
en
in
s
ig
h
ts
to
th
e
MD
T
M
co
m
m
ittee.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
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8
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20
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2
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b.
MD
T
M
d
o
cu
m
en
t
m
an
ag
e
m
en
t
ap
p
licatio
n
:
m
a
n
ag
es
th
e
d
o
cu
m
en
ts
an
d
r
ec
o
r
d
s
,
en
s
u
r
in
g
t
h
at
d
o
cu
m
e
n
tatio
n
is
s
tr
ea
m
lin
ed
an
d
ac
ce
s
s
ib
le
d
u
r
in
g
MD
T
m
ee
tin
g
s
.
T
h
ese
a
p
p
l
i
c
a
t
i
o
n
s
ar
e
in
ter
co
n
n
ec
ted
th
r
o
u
g
h
a
s
er
ies
of
API
s
,
en
s
u
r
in
g
s
ea
m
less
d
ata
f
lo
w
an
d
s
u
p
p
o
r
tin
g
s
ca
lab
ilit
y
an
d
f
u
t
u
r
e
en
h
an
ce
m
en
ts
.
T
h
e
d
ata
ar
ch
itectu
r
e
its
elf
is
m
an
if
ested
th
r
o
u
g
h
cr
itical
d
a
t
a
o
b
jects
s
u
ch
as
MD
T
M
s
h
ee
ts
an
d
E
HR
s
u
m
m
ar
ies,
ess
en
tial
f
o
r
th
e
o
p
er
atio
n
al
in
teg
r
ity
o
f
th
e
ap
p
licatio
n
l
a
y
e
r
.
T
h
e
in
teg
r
atio
n
o
f
th
ese
ap
p
l
icatio
n
s
an
d
th
eir
ass
o
ciate
d
s
er
v
ices
in
to
o
u
r
en
ter
p
r
is
e
a
r
ch
itectu
r
e
estab
lis
h
es
a
r
o
b
u
s
t
f
r
am
ewo
r
k
d
esig
n
e
d
to
en
h
an
ce
th
e
ef
f
icien
cy
an
d
e
f
f
ec
tiv
en
ess
o
f
MD
T
M
o
p
er
atio
n
s
.
B
y
in
co
r
p
o
r
atin
g
ad
v
a
n
ce
d
te
ch
n
o
lo
g
ical
ca
p
ab
ilit
ies,
s
u
ch
as
AI
-
d
r
iv
en
d
ec
is
io
n
s
u
p
p
o
r
t
an
d
s
ea
m
less
d
ata
in
ter
o
p
er
a
b
ilit
y
,
th
e
ar
ch
itect
u
r
e
a
d
d
r
ess
es
cr
itical
g
ap
s
i
n
cu
r
r
en
t
MD
T
M
wo
r
k
f
lo
w
s
.
T
h
is
alig
n
m
e
n
t
b
etwe
en
tech
n
o
lo
g
y
an
d
b
u
s
i
n
ess
p
r
o
ce
s
s
es
en
s
u
r
es
th
at
t
h
e
MD
T
M
co
m
m
ittee
h
as
ac
ce
s
s
to
r
ea
l
-
tim
e,
ac
cu
r
ate
in
f
o
r
m
atio
n
a
n
d
c
o
ll
ab
o
r
ativ
e
to
o
ls
,
e
n
ab
lin
g
th
e
m
to
m
ak
e
well
-
in
f
o
r
m
ed
an
d
tim
ely
d
ec
is
io
n
s
.
Ultim
ately
,
th
is
ap
p
r
o
ac
h
n
o
t
o
n
ly
s
tr
ea
m
lin
es
o
p
e
r
atio
n
al
wo
r
k
f
lo
ws
b
u
t
also
d
ir
e
ctly
co
n
tr
ib
u
tes
to
im
p
r
o
v
e
d
p
atien
t
o
u
tco
m
es
b
y
s
u
p
p
o
r
tin
g
e
v
id
en
ce
-
b
ased
t
r
ea
tm
en
t
p
lan
n
in
g
a
n
d
f
o
s
ter
i
n
g
a
m
o
r
e
c
o
h
esiv
e
m
u
ltid
is
cip
lin
ar
y
ap
p
r
o
ac
h
to
o
n
co
lo
g
y
ca
r
e.
Fig
u
r
e
5
.
B
u
s
in
ess
an
d
ap
p
licatio
n
r
ep
r
esen
tatio
n
3
.
4
.
Appl
ica
t
io
n
a
n
d
t
e
c
hn
o
lo
g
y
l
a
y
e
r
s
T
h
e
f
o
u
n
d
atio
n
of
an
y
e
n
ter
p
r
is
e
s
o
lu
tio
n
lies
in
a
r
o
b
u
s
t
tech
n
o
lo
g
y
in
f
r
astru
ctu
r
e.
Ar
ch
iMa
te
m
o
d
els
th
is
tech
n
o
lo
g
y
lay
er
ef
f
ec
tiv
ely
,
em
p
lo
y
in
g
elem
e
n
ts
lik
e
n
o
d
es,
wh
ich
em
b
o
d
y
p
latf
o
r
m
s
s
u
ch
as
th
e
AI
s
er
v
ice
an
d
th
e
E
NOVA
R
&
T
s
o
lu
tio
n
.
T
h
ese
n
o
d
es
d
ep
lo
y
c
r
u
cial
tech
n
o
lo
g
y
elem
en
ts
an
d
h
o
s
t
s
y
s
tem
s
o
f
twar
e,
lik
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f
ile
m
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tem
s
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d
AI
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n
g
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es,
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g
r
al
f
o
r
o
p
e
r
atio
n
al
s
u
p
p
o
r
t.
I
n
o
u
r
s
p
ec
if
ic
ar
ch
itectu
r
al
f
r
am
ew
o
r
k
,
in
Fig
u
r
e
6,
th
e
AI
e
n
g
i
n
e
is
h
o
s
ted
o
n
a
p
h
y
s
ical
s
e
r
v
er
,
c
r
itical
f
o
r
th
e
o
p
er
atio
n
s
o
f
o
u
r
s
y
s
tem
,
f
ac
il
itatin
g
ess
en
tial ta
s
k
s
s
u
ch
as tr
ain
in
g
AI
m
o
d
els.
T
h
is
in
f
r
astru
ctu
r
e
is
m
etic
u
lo
u
s
ly
lin
k
ed
to
th
e
a
p
p
li
ca
tio
n
lay
er
,
with
tech
n
o
lo
g
y
s
er
v
ices
en
h
an
cin
g
th
e
f
u
n
ctio
n
ality
o
f
ap
p
licatio
n
c
o
m
p
o
n
en
ts
.
T
h
ese
s
er
v
ices
p
er
f
o
r
m
d
ata
m
an
ag
em
en
t
task
s
ess
en
tial
f
o
r
o
p
e
r
atio
n
al
in
te
g
r
ity
,
ex
em
p
lifie
d
b
y
t
h
e
E
NO
VAR&T
d
atab
ase
m
an
ag
in
g
MD
T
M
s
h
ee
ts
an
d
E
HR
s
u
m
m
ar
ies.
T
h
e
s
ea
m
less
in
ter
ac
tio
n
b
etwe
en
th
e
ap
p
licatio
n
an
d
tech
n
o
lo
g
y
lay
e
r
s
u
n
d
er
s
co
r
es
th
e
s
y
s
tem
’
s
ef
f
icien
cy
in
d
ata
h
a
n
d
lin
g
a
n
d
p
r
o
ce
s
s
f
ac
ilit
atio
n
.
Fu
r
th
er
m
o
r
e
,
o
u
r
a
r
ch
itectu
r
e
s
h
o
ws
th
at
th
e
E
NOVA
R
&
T
s
o
lu
tio
n
,
p
ar
ticu
lar
ly
i
ts
MD
T
M
m
an
ag
em
en
t m
o
d
u
le,
is
m
o
d
u
lar
an
d
r
ep
lace
ab
le.
T
h
is
m
o
d
u
lar
ity
en
s
u
r
es th
at
o
u
r
en
te
r
p
r
is
e
ar
ch
itectu
r
e
ca
n
in
ter
f
ac
e
with
an
y
h
ea
lth
in
f
o
r
m
atio
n
s
y
s
tem
(
HI
S)
p
r
o
v
id
er
,
e
n
h
an
cin
g
its
v
er
s
atility
ac
r
o
s
s
v
ar
io
u
s
tech
n
o
lo
g
ical
ec
o
s
y
s
tem
s
.
T
h
is
m
o
d
u
lar
ity
,
alo
n
g
with
th
e
u
s
e
o
f
lo
o
s
ely
co
u
p
led
s
er
v
i
ce
s
,
em
p
h
asizes
th
e
ar
ch
itectu
r
e’
s
s
ca
lab
ilit
y
an
d
a
d
ap
tab
ilit
y
,
m
ak
i
n
g
it u
n
iv
er
s
a
lly
ap
p
licab
le.
3
.
5
.
Co
m
pa
riso
n wit
h e
x
is
t
ing
s
t
ud
ies
Ou
r
f
in
d
in
g
s
s
u
g
g
est
th
at
th
e
p
r
o
p
o
s
ed
ar
ch
itectu
r
e
a
d
d
r
es
s
es
s
ev
er
al
k
ey
ch
allen
g
es
id
en
tifie
d
in
p
r
ev
io
u
s
r
esear
ch
o
n
MD
T
M
an
d
AI
in
teg
r
atio
n
.
Fo
r
ex
a
m
p
le,
wh
ile
s
tu
d
ies
s
u
ch
as
W
atso
n
f
o
r
o
n
co
lo
g
y
an
d
th
e
o
n
co
lo
g
y
e
x
p
er
t
ad
v
is
o
r
h
a
v
e
d
em
o
n
s
tr
ated
th
e
p
o
te
n
tial
o
f
AI
in
clin
ical
d
ec
is
io
n
s
u
p
p
o
r
t,
th
e
y
h
av
e
also
h
ig
h
lig
h
ted
lim
itatio
n
s
r
elate
d
to
s
y
s
tem
in
ter
o
p
er
a
b
ilit
y
an
d
ad
a
p
tab
ilit
y
to
s
p
ec
if
i
c
clin
ical
co
n
tex
ts
[
2
5
]
,
[
2
7
]
.
Ou
r
ar
ch
itectu
r
e
at
tem
p
ts
to
o
v
er
co
m
e
th
ese
lim
itatio
n
s
b
y
em
p
h
asizin
g
m
o
d
u
lar
ity
,
s
ca
lab
ilit
y
,
an
d
th
e
in
te
g
r
atio
n
o
f
AI
m
o
d
els tailo
r
ed
to
th
e
o
n
co
lo
g
y
d
o
m
ain
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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t J E
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&
C
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p
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I
SS
N:
2088
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8
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To
w
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r
d
s
a
s
ta
n
d
a
r
d
iz
ed
en
terp
r
is
e
a
r
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itectu
r
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en
h
a
n
cin
g
…
(
N
a
s
s
im
B
o
u
t
)
2233
Fig
u
r
e
6.
Ap
p
licatio
n
an
d
tech
n
o
lo
g
y
r
e
p
r
e
s
e
n
t
a
t
i
o
n
T
h
e
u
s
e
o
f
Ar
c
h
iMa
te
an
d
T
OGAF
f
r
am
ewo
r
k
s
in
o
u
r
ap
p
r
o
ac
h
en
s
u
r
es
th
at
th
e
p
r
o
p
o
s
ed
ar
ch
itectu
r
e
is
b
o
th
t
h
eo
r
etica
l
ly
r
o
b
u
s
t
an
d
p
r
ac
tically
ap
p
li
ca
b
le,
ad
d
r
ess
in
g
th
e
u
n
iq
u
e
c
h
allen
g
es
f
ac
ed
in
d
iv
er
s
e
h
ea
lth
ca
r
e
s
ettin
g
s
.
U
n
lik
e
ea
r
lier
m
o
d
els,
wh
ich
o
f
ten
lack
ed
ad
a
p
tab
ilit
y
o
r
wer
e
n
ar
r
o
wly
f
o
cu
s
ed
,
o
u
r
ar
c
h
itectu
r
e
is
d
esig
n
ed
t
o
b
e
v
er
s
atile,
p
r
o
v
id
in
g
a
s
ca
lab
le
s
o
lu
tio
n
th
at
alig
n
s
with
th
e
d
y
n
am
ic
an
d
m
u
ltid
is
cip
lin
ar
y
n
atu
r
e
o
f
M
DT
Ms.
B
y
lev
er
ag
in
g
th
ese
e
s
tab
lis
h
ed
f
r
am
ewo
r
k
s
,
th
e
a
r
ch
itectu
r
e
f
ac
ilit
ates
s
ea
m
less
in
teg
r
atio
n
with
ex
is
tin
g
s
y
s
tem
s
wh
ile
m
ain
tain
in
g
th
e
f
lex
ib
ilit
y
to
ac
co
m
m
o
d
a
te
ad
v
an
ce
m
e
n
ts
in
h
ea
lth
ca
r
e
tech
n
o
lo
g
y
.
W
h
en
co
n
tex
tu
alize
d
with
in
th
e
b
r
o
ad
er
s
co
p
e
o
f
ex
is
tin
g
r
esear
ch
,
o
u
r
f
in
d
in
g
s
h
ig
h
lig
h
t
th
e
s
ig
n
if
ican
ce
o
f
th
is
ar
c
h
itectu
r
e
as
a
f
o
u
n
d
atio
n
al
m
o
d
el
f
o
r
f
u
tu
r
e
s
tu
d
ies.
Sp
ec
if
ically
,
t
h
e
ar
ch
itectu
r
e'
s
AI
-
d
r
iv
en
d
ec
is
io
n
s
u
p
p
o
r
t
ca
p
ab
i
liti
es
o
f
f
er
an
in
n
o
v
ativ
e
a
p
p
r
o
ac
h
to
en
h
a
n
cin
g
MD
T
M
o
p
er
atio
n
s
,
p
av
i
n
g
t
h
e
way
f
o
r
em
p
ir
ical
test
in
g
to
v
alid
ate
its
p
r
ac
tical
b
en
ef
its
.
Su
ch
f
u
tu
r
e
s
tu
d
ies
co
u
ld
ev
a
lu
ate
th
e
im
p
ac
t
o
f
AI
-
en
h
an
ce
d
MD
T
Ms
o
n
cli
n
ical
wo
r
k
f
lo
ws,
d
ec
is
io
n
-
m
ak
in
g
ef
f
icien
cy
,
a
n
d
p
atien
t
o
u
tco
m
es,
th
e
r
eb
y
co
n
tr
ib
u
tin
g
to
th
e
o
n
g
o
in
g
a
d
v
an
ce
m
e
n
t
o
f
d
ig
ital
h
ea
lth
ca
r
e
tech
n
o
lo
g
ies
an
d
s
ettin
g
n
ew
s
tan
d
ar
d
s
f
o
r
m
u
ltid
is
cip
lin
ar
y
co
llab
o
r
atio
n
in
o
n
co
lo
g
y
ca
r
e.
I
n
s
u
m
m
ar
y
,
th
is
s
tu
d
y
s
er
v
es
as
a
f
o
u
n
d
atio
n
al
ex
p
l
o
r
atio
n
o
f
th
e
in
teg
r
atio
n
o
f
AI
with
in
MD
T
M,
o
f
f
er
in
g
a
co
n
ce
p
tu
al
f
r
am
e
wo
r
k
d
esig
n
ed
t
o
im
p
r
o
v
e
d
ec
is
io
n
-
m
ak
in
g
p
r
o
ce
s
s
es
in
o
n
co
l
o
g
y
.
W
h
ile
em
p
ir
ical
v
alid
atio
n
is
n
ec
ess
ar
y
to
f
u
lly
ass
ess
th
e
p
r
o
p
o
s
ed
ar
ch
itectu
r
e’
s
ef
f
ec
tiv
e
n
ess
,
th
is
wo
r
k
lay
s
th
e
g
r
o
u
n
d
wo
r
k
f
o
r
f
u
tu
r
e
r
esear
ch
in
th
is
ar
ea
.
B
y
p
r
o
p
o
s
in
g
an
ad
a
p
tab
le,
m
o
d
u
lar
,
an
d
s
ca
lab
le
en
ter
p
r
is
e
ar
ch
itectu
r
e,
o
u
r
aim
is
to
in
s
p
ir
e
s
u
b
s
eq
u
en
t
s
tu
d
ies
th
at
will
em
p
ir
ically
test
an
d
r
ef
in
e
th
is
f
r
am
ewo
r
k
in
d
iv
er
s
e
h
ea
lth
ca
r
e
s
ettin
g
s
.
T
h
e
f
o
ll
o
win
g
s
ec
tio
n
s
will
e
x
p
lo
r
e
p
o
ten
tial
c
h
allen
g
es
a
n
d
o
p
p
o
r
t
u
n
ities
f
o
r
f
u
r
th
er
d
ev
elo
p
m
en
t in
t
h
is
p
r
o
m
is
in
g
f
ield
.
4.
C
O
N
CL
US
I
O
N
T
h
is
p
ap
er
p
r
esen
ts
th
e
c
o
n
c
ep
tu
al
d
e
v
elo
p
m
e
n
t
o
f
a
n
o
v
el
en
ter
p
r
is
e
a
r
ch
itectu
r
e
f
o
r
MD
T
Ms
in
o
n
co
lo
g
y
,
in
teg
r
atin
g
ad
v
an
c
ed
tech
n
o
lo
g
ies
an
d
AI
to
en
h
an
ce
clin
ical
wo
r
k
f
lo
ws
an
d
d
ec
is
io
n
-
m
ak
i
n
g
p
r
o
ce
s
s
es.
T
h
e
th
eo
r
etica
l
f
o
u
n
d
atio
n
s
o
f
th
e
ar
ch
itect
u
r
e
p
r
o
v
id
e
a
co
m
p
r
eh
en
s
i
v
e
f
r
am
ewo
r
k
th
at
estab
lis
h
es
a
s
o
lid
b
ase
f
o
r
f
u
tu
r
e
em
p
ir
ical
s
tu
d
ies,
aim
in
g
to
r
ev
o
lu
tio
n
ize
MD
T
M
p
r
ac
tices
an
d
s
ig
n
if
ican
tly
im
p
r
o
v
e
p
atie
n
t
ca
r
e
o
u
tco
m
es.
B
y
ad
d
r
e
s
s
in
g
th
e
co
m
p
lex
ities
o
f
o
n
co
lo
g
y
ca
r
e,
t
h
is
ar
ch
itectu
r
e
p
r
o
p
o
s
es
a
m
eth
o
d
t
o
s
tan
d
a
r
d
ize
a
n
d
s
tr
ea
m
lin
e
d
ec
is
io
n
-
m
ak
in
g
p
r
o
ce
s
s
es
wh
ile
ac
co
m
m
o
d
atin
g
th
e
s
p
ec
if
ic
n
ee
d
s
o
f
m
u
ltid
is
cip
lin
ar
y
co
lla
b
o
r
atio
n
.
T
h
e
p
r
o
p
o
s
ed
ar
ch
itectu
r
e
is
s
p
ec
if
ically
d
esig
n
ed
to
ass
is
t
MD
T
M
atten
d
ee
s
in
s
elec
tin
g
th
e
m
o
s
t
ef
f
ec
tiv
e
tr
ea
tm
en
t
p
lan
s
f
o
r
p
atien
ts
b
y
lev
er
ag
in
g
AI
-
g
en
er
ated
r
ec
o
m
m
e
n
d
atio
n
s
ta
ilo
r
ed
to
in
d
iv
id
u
al
ca
s
es.
T
h
r
o
u
g
h
th
e
s
tr
ateg
ic
in
teg
r
atio
n
o
f
b
u
s
in
ess
,
ap
p
licati
o
n
,
an
d
tech
n
o
lo
g
y
lay
er
s
,
it
e
n
h
an
ce
s
wo
r
k
f
lo
w
ef
f
icien
cy
,
d
ec
is
io
n
-
m
ak
i
n
g
ac
cu
r
ac
y
,
a
n
d
d
ata
in
ter
o
p
er
ab
ilit
y
.
T
h
e
d
etailed
m
o
d
elin
g
u
n
d
er
s
co
r
es
its
s
ig
n
if
ican
t
p
o
ten
tial
b
e
n
ef
its
,
alth
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