1. CHEAR (Child Health Environmental Assessment Resource) Use Case
Associations between phthalates and body size measures in children
Team Members: Yue Liu (Robin) Zhicheng Liang (Jason) Anirudh Prabhu John Sheehan

2. Summary
Phthalates: One class of Endocrine Disrupting Chemicals (EDC) may impact obesity because of estrogenic and anti-estrogenic properties.
Researchers want to analyze and understand the relationship between phthalates exposure and growth (body size composition) in children.
If associations are found, what are the effect sizes of the differences? What are the concentrations needed to affect body size composition? Which phthalates in particular are associated with which specific outcomes?

3. Triggers High concentrations of phthalates biomarkers in children.
High incidence of obesity in children.
Associations have been reported for phthalates and increased body weight in children and animal studies.
Mechanism include estrogenic or anti-estrogenic properties of phthalates.
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4. Use Case Diagram Basic / Normal Flow of Events Step Actor (Person)
Actor (System)
Description 1
User
identifies one of the trigger conditions 2
Accesses the interface 3
Types in a question related to phthalates biomarkers or obesity in children. 4
System
Queries the ontology for information 5
retrieves the answer from one or more terms present in or inferred from the ontology/knowledge base 6
Exits the system after reading the answer

5. Use Case Diagram (Alternate Flow)
Alternate Flow of Events
Step
Actor (Person)
Actor (System)
Description 1
User
Identifies one of the trigger conditions 2
Accesses the interface 3
Types in a question related to phthalates biomarkers or obesity in children. 4
System
queries the ontology for information 5
Cannot find an answer present in the ontology/knowledge base 6
Offers to perform acronym expansion for the ambiguous terms or asks the user to rephrase the question 7
Selects one of the above options 8
Uses the new version of the question to retrieve answers using the ontology 9
Exits the system after reading the answer

6. Use Case Diagram (Exception Flow)
Exception Flow of Events
Step
Actor (Person)
Actor (System)
Description 1
User
Identifies one of the trigger conditions 2
Accesses the interface
Exception Flow of Events
Step
Actor (Person)
Actor (System)
Description 1
User
Identifies one of the trigger conditions 2
Accesses the interface 3
Types in a question phthalates biomarkers or obesity in children.
System
Does not have an answer to the question 5
Points the user to other questions asked with similar tags, while displaying an Error message to the user. 6
Gives the user an option of rephrasing the question or exiting the application. 7
Exits the system.

7. Resources
Associations between phthalates and body size measures in children

8. Resources

9. Ontology Data Flow
Key Terms within the question are defined within these Ontologies
Data on Phthalate Biomarkers compared
with baseline
User poses a question to the system
Baseline growth data for children acquired from this Ontology
Results of Comparison
presented to User

10. Competency Questions
Example Question: Do girls with high concentrations of phthalates have on average a higher BMI than boys?
Answer: Yes. Average BMI of girls who use a lot of personal care products is 24.4 vs boys who use a lot of personal care products. Since phthalates work as softeners in personal care products, people who use a lot of personal care products tend to have high concentrations of phthalates. Therefore girls with high concentration of phthalates have higher bmi than boys with high concentration of phthalates. The ontology would have key terms included in the question including BMI and would also contain anchors to existing ontologies (ex. SNOMED CT) on average BMIs for children (not necessarily with high concentrations of phthalates) but of different age ranges and other demographic criteria. It would query these knowledge bases to obtain the result.

11. Competency Questions Example of Body Mass Index with SNOMED CT

12. Thank You.