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The two main purposes of clinical decision-support systems (CDSSs) are to provide healthcare professionals decision-making support based on evidence-based medical knowledge, and a continuing medical education. This thesis focuses on both purposes and shows how fundamental theory in the field of artificial intelligence can be developed, adapted and implemented in a CDSS for supporting learning and diagnostic reasoning in clinical practice. The main research problems addressed in this thesis are how to represent and manage uncertain, incomplete, inconsistent and distributed knowledge in automated reasoning and decision-making with the clinicians in the loop, how to facilitate the knowledge engineering and maintenance process, and how to detect and support learning and skill development in CDSS users. Research contributions include theories, methods, and algorithms based on possibilistic logic and formal argumentation for representing and managing uncertain, incomplete, inconsistent and distributed medical knowledge, and for supporting reasoning and decision-making when using a CDSS. The clinician is provided potentially conflicting arguments and their strength based on different diagnostic criteria and the available patient information in order to make an informed decision. The theoretical results were implemented in the Dementia Diagnosis and Management Support System - Web version (DMSS-W), in a multi-agent hypothesis-driven inquiry dialogue system, and in an inference engine serving as a module of ACKTUS. CDSS maintenance is challenging since new knowledge about diseases and treatments are continuously developed. Typically, knowledge and software engineers are needed to bridge medical experts and CDSSs, leading to time-consuming system development. ACKTUS (Activity-Centered Knowledge and Interaction Tailored to Users) was, as part of this research, further developed as a generic web-based platform for knowledge management and end-user development of CDSSs. It inclu

A common conversation between an older adult and a nurse about health-related issues includes topics such as troubles with sleep, reasons for walking around nighttime, pain conditions, etc. Such a dialogue can be regarded as a "natural" dialogue emerging from the participating agents' lines of thinking, their roles, needs and motives, while switching between topics as the dialogue unfolds. The purpose of this work is to define a generic conceptual model of purposeful human-agent dialogue activity including different types of argumentation dialogues, suitable for health-related topics. This is done based on analyses of a scenario, persona and models of human behaviour. The model will be shared between the human and the agent, allowing for adaptation to the human's reasoning, needs and motives.

The main purpose of assistive technology is to support an individual's daily activities, in order to increase ability, autonomy, relatedness and quality of life. The aim for the work presented in this article is to develop automated methods to tailor the behavior of the assistive technology for the purpose to provide just-in-time, adaptive interventions targeting multiple domains. This requires methods for representing and updating the user model, including goals, preferences, abilities, activity and its situation. We focus the assessment and intervention tasks typically performed by therapists and provide knowledge-based technology for supporting the process. A formative evaluation study was conducted as a part of a participatory action research process, involving two rehabilitation experts, two young individuals and one senior individual as end-user participants, in addition to knowledge engineers. The main contribution of this work is a theory-based method for assessing the individual's goals, preferences, abilities and motives, which is used for building a holistic user model. The user model is continuously updated and functions as the base for tailoring the system's assistive behavior during intervention and follow-up.

There is a major goal in the mining industry to reduce risks and maintain health in work environments. Moreover, the industry is obliged to monitor the risks in work environment as well as employers’ health statuses. The potentials in using ambient information for the purpose to reduce risks, prevent work-related injuries and monitor health in individuals has been explored. Applications tailored to the individual are being developed to aid the worker in mining or mining-related work environments in valuing the risks of their work situation and create awareness in the individual about how he or she can decrease risks for primarily physical damages. The purpose is to encourage the worker to act upon the level of risk for injuries, and upon the new insights the worker gain from the applications. The identified opportunities for and obstacles to integrating ambient information in these health applications are discussed.

It is argued that a development of healthcare systems should emerge within a healthcare providing organization and as part of daily practice instead of something implemented by a third party, in order to become successful. This sociotechnical view on system development is shared with new methods developed in the end-user development field. However, is it possible to realize this in practice? This paper explores the obstacles and potentials in the realization, leading to a discussion about sociotechnical systems as innovation systems. We describe two examples of sociotechnical innovation systems, and discuss the results from an end user driven innovation process perspective.

Existing approaches to ambient assisted living (AAL) often fail to consider a human agent's needs from a holistic perspective. In particular, the regular assessment of their changing abilities, skills and limitations are often treated as a separate matter in healthcare, thereby affecting the possibilities to provide support tailored to their current condition. Therefore, the objective of this work is to integrate assessment done by the healthcare professional into the framework of AAL. We use a case scenario as base for domain experts in their development of the interaction between software agents and with the older adult in assessment and adaptation for supporting him/her in a home environment. The potentials in allowing professionals author and design the dialogue systems as part of a meta-design process is evaluated and discussed.